October 29, 2018
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Nearly 40% of adults do not know shingles vaccine exists

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Only 38% of adults in the U.S. knew a vaccine for shingles was available, a survey by the American Osteopathic Association recently found.

The findings did not surprise Kathryn Edwards, MD, a spokesperson for the Infectious Diseases Society of America and professor within the division of pediatric infectious diseases at the Vanderbilt University School of Medicine.

“The health care community has struggled with increasing vaccine awareness among adults for years,” she told Healio Family Medicine.

“The vaccine schedule for adult patients is not as well understood and not as well implemented as its counterpart for pediatric patients. This is likely because most adults do not need to get vaccines to go to work unless they work in health care, whereas children often need proof of vaccines to go to school,” she continued.

The American Osteopathic Association stated in a press release that Shingrix, which received FDA approval last year, was found to be 97% effective in adults aged 50 to 69 years, and more than 90% effective in those 70 years of age as well as those “well past 80 [years of age].” The group also stated that the vaccine can now be administered in patients 50 years of age and older which is 10 years earlier than previous versions.

“This is an unprecedented opportunity to nearly eliminate shingles among our patient population, as well as the possibility of chronic pain or even blindness that can accompany the condition,” Judith Lightfoot, DO, an infectious disease specialist at Rowan University School of Osteopathic Medicine said in the release. “It's a prevention conversation I'm having with nearly every patient over 50.”

According to HHS’s website, adults older than 50 years even those who have already had shingles, have been vaccinated against the disease with Zostavax, or are not sure if they have had the chickenpox should receive two doses of Shingrix. The second dose is administered 2 to 6 months after the first one. 

Patients should not get the Shingrix vaccine if they currently have shingles, have ever had a severe allergic reaction to any ingredient in the vaccine or after a dose of Shingrix, are not immune to the virus that causes chickenpox or are pregnant or breastfeeding, the HHS also stated.

Edwards offered tips for primary care physicians to starting conversations on the shingles vaccine with their patients.

“Send out mailings or send texts before appointments to patients who have not been vaccinated. You can also hang signs in your waiting room or in your examination room that cue the patient’s memory to ask you about the shingles vaccine,” she said. “I would also advise that you make sure your electronic health record has all the current popups for immunizations.”

Edwards added that although office visits are short with many things to cover, and only one in three adults will get shingles in their lifetime, the shingles vaccine is still one of the most important things that primary care physicians can discuss with their adult patients.

“Shingles is a serious, severe illness that can leave adults in severe pain, cause eye damage, lead to hearing problems, encephalitis and sometimes, in rare instances, death. If we can get the shingles vaccine front and center in the minds of our patients, that would be ideal,” she said.

“Since we don’t have a lot of good treatments for shingles, the adage ‘an ounce of prevention is worth a pound of cure’ really applies here,” Edwards added.

“The physical and emotional comfort of [vaccines] … far outweighs the limited discomfort related to the two recommended shots,” Lightfoot said in the release.

Adverse events tied to the Shingrix vaccine include headache, feeling tired, muscle pain, shivering, fever, stomach pain or upset stomach or pain, swelling, or redness at the injection site. These events are usually mild and go away within a few days, the HHS website stated. - by Janel Miller

References:

“Survey Finds Less than Two-Thirds of Americans (62%) Know a Preventive Vaccine is Available for Shingles.” https://www.prnewswire.com/news-releases/survey-finds-less-than-two-thirds-of-americans-62-know-a-preventive-vaccine-is-available-for-shingles-300664882.html. American Osteopathic Association. Accessed Oct. 22, 2018.

Vaccines.gov. https://www.vaccines.gov/diseases/shingles/index.html. Shingles (Herpes Zoster). Accessed Oct 22, 2018.

Disclosures: Edwards reports no relevant financial disclosures. Healio Family Medicine was unable to determine Lightfoot’s relevant financial disclosures prior to publication.