Gaps in RZV Knowledge, Practice Among Specialty Health Care Providers Remain


Immunocompromised adults aged 19 years or older are eligible to receive the recombinant zoster vaccine.

Although most specialist health care providers recommend vaccination for herpes zoster to their patients, there remain numerous gaps in knowledge and practice. This is according to a poster1 presented at the American Society of Health-System Pharmacists (ASHP) 2022 Midyear Clinical Meeting and Exhibition, held December 4 to 8 in Las Vegas, Nevada.

In 2018, the Advisory Committee on Immunization Practices (ACIP) recommended vaccination with the recombinant zoster vaccine (RZV) for prevention of herpes zoster in immunocompromised adults aged 50 years and older. In January 2022, this recommendation was extended to include immunocompromised adults aged 19 years and older.

To evaluate knowledge, attitudes, and practice of health care providers, Investigators conducted a cross-sectional, web-based survey of 613 physicians in the United States across several specialties (dermatology, gastroenterology, oncology, rheumatology, and infectious diseases) who reported caring for adults with psoriasis, inflammatory bowel disease, cancer, rheumatoid arthritis, or HIV. Most respondents reported working in private group practice or at an academic center (43% and 25%, respectively), with 49% and 46% working in an urban or suburban center, respectively.

Among respondents, 94% reported recommending vaccines to their adult patients; fewer reported that they prescribe or administer vaccines (55% and 36%) to their patients. Forty-three percent of respondents were able to correctly identify all FDA-approved indications for RZV; however, they were less knowledgeable about ACIP recommendations. Only 29% of respondents were aware that RZV is recommended for patients who had previously received the zoster vaccine live.

Overall, respondents reported having a conversation with their patients about herpes zoster vaccination with a mean of 42%±33% of their patients with a disease of interest. Within that group, oncologists and dermatologists reported the lowest percentages of discussions (37%±31% and 24%±26%, respectively). The primary reason why specialists reported not having these conversations was “more urgent or acute issues to be discussed during the appointment,” according to researchers.

“Most specialists reported recommending vaccines, but this survey identified gaps in knowledge and practices regarding HZ vaccination,” the researchers concluded. “It is important to address these gaps given the risk of HZ in the [immunocompromised] populations that these specialists often care for and considering the recent ACIP recommendation supporting RZV vaccination for [immunocompromised] populations.”


  1. Singer D, Sweeny C, Reynolds M, Poston S. Assessing awareness and implementation of herpes zoster vaccine recommendations by subspecialists in the United States. Presented at: American Society of Health-System Pharmacists 2022 Midyear Clinical Meeting and Exhibition; December 4-8, 2022; Las Vegas, NV. Poster 4-033.
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