Physicians On-board with Herpes Zoster Vaccine

October 7, 2019

More doctors referring patients to pharmacies for shots.

Physicians’ attitudes toward herpes zoster (HZ) and vaccination to prevent it appear to be more favorable after a decade of availability of a vaccine, according to a newly published study

Researchers at the CDC and the University of Colorado Denver’s Vaccine Policy Collaborative Initiative analyzed data from three surveys administered to primary care physicians in 2005, 2008, and 2016. Over those years, Zostavax was licensed by the FDA in 2006, and Shingrix was approved by the FDA and recommended by the CDC Advisory Committee on Immunization Practices in 2017 as the preferred vaccine for people 50 and older.

The data reveal that: 

  • 60% of the physicians surveyed in 2016 strongly agreed that HZ and complications like postherpetic neuralgia cause a significant burden of disease for older patients. Just 35% of those surveyed in 2005 held the same view. 

  • 68% of the 2016 respondents strongly agreed that the burden of HZ and its complications in patients 60 to 79 years old was sufficient to make vaccination important, compared to just 34% in 2005. 

  • 77% of those surveyed in 2016 strongly recommended the HZ vaccine to eligible patients 60 or older, compared to 41% in 2008.

Physicians who participated in the studies also identified patient cost as the biggest barrier to vaccination. Their concerns over safety and efficacy diminished over the course of the three surveys.

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Researchers also discovered that while a similar percentage of surveyed physicians reported stocking the vaccine in their offices in 2008 and 2016, a significantly greater number of them indicated in 2016 that they had stopped administering the vaccine as a result of cost and reimbursement issues. Physicians were also more likely to refer patients to pharmacies to purchase and receive the vaccine in 2016 (77%) than in 2008 (33%).

Mitchel C. Rothholz, RPh, MBA, and chief strategy officer at the American Pharmacists Association (APhA) says many community pharmacists are already benefiting from physicians’ changing practices. 

“About 60 to 70% of community independent pharmacies are doing immunizations, and all of the chains are doing immunizations,” he notes. “It’s critical that community pharmacies provide access for the public for these important vaccines that prevent disease.”

 

Regarding the payment model, Rothholz adds that pharmacists also have an advantage, particularly when it comes to Medicare patients. “The shingles vaccine is paid under Part D, so that’s a drug benefit payment versus a medical payment. Of course, pharmacies are involved in that, but it’s a lot more work for physicians that they don’t want to do,” he explains. 

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APhA recognizes the importance of vaccinations across the patient’s lifespan, Rothholz continues, noting that the organization has spent the last 25 years preparing community pharmacists for and supporting them in their role as valued healthcare providers and administrators of vaccinations. 

“We coined the term ‘immunization neighborhood’, which is built around the three Cs: collaboration, coordination, and communication,” he says. 

“Pharmacists must be knowledgeable across all vaccines so that they’re a knowledgeable resource for public health departments and others in the community,” he concludes, encouraging them to take a proactive role in their communities. “When there’s misinformation out there about vaccines, they can help educate their patients and guide them through their needs. They can either administer it, offer it, or refer the patient to a practitioner who can administer it.” 

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