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Cost Barriers Hamper Herpes Zoster Vaccination of Seniors

The vaccine is well tolerated, but financial barriers among physicians hinder broader uptake

TUESDAY, May 4 (HealthDay News) -- Though most physicians recommend the use of herpes zoster vaccine in older adults, they are hampered by its financial barriers, according to survey results published in the May 4 issue of the Annals of Internal Medicine. A study in the same issue found that the vaccine is well tolerated in older adults.

Laura P. Hurley, M.D., of the University of Colorado in Denver, and colleagues conducted a mail and Internet-based survey of family physicians and general internists (598 responded) on their use of the $200-per-dose vaccine, which has had only 2 to 7 percent uptake nationally. They found that 88 percent of respondents said they recommended the vaccine and 41 percent strongly recommended it, but only 45 percent knew that the vaccine is reimbursed through Medicare Part D. Twelve percent of those who began administering the vaccine said they stopped because of cost and reimbursement problems.

In another study, Michael S. Simberkoff, M.D., of the New York University School of Medicine in New York City, and colleagues studied adverse events in 38,546 immunocompetent adults age 60 or older who received herpes zoster vaccine or placebo, including 6,616 subjects in an adverse events substudy. They found that 1.4 percent of vaccine recipients and 1.4 percent of placebo recipients reported serious adverse events. In the substudy, among those vaccinated, 48 percent reported local inoculation-site side effects compared to 16 percent for placebo. The local side effects occurred more commonly in those 60 to 69 than those 70 and older.

"Given the substantial protection that herpes zoster vaccine provides against the occurrence and morbidity of herpes zoster and, specifically, postherpetic neuralgia, we believe that this safety profile supports the recommendation for routine use of herpes zoster vaccine in immunocompetent older adults, who are at increased risk for herpes Zoster and its complications," Simberkoff and colleagues conclude.

Grant support provided in part by Merck for Simberkoff study. The lead authors in both studies also disclosed financial relationships with pharmaceutical companies.

Abstract - Hurley
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Abstract - Simberkoff
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