My Spouse Had Shingles: Seeing is Believing

What will it take to increase zoster immunization uptake among our nation's senior population?

Approximately 1 million Americans develop herpes zoster or shingles every year, and for many of them, its residual effect is postherpetic neuralgia. Since 2006, clinicians have been able to offer a vaccination to help adults who are 60 years of age or older fight off shingles. Despite public health campaigns and ample quantities of direct-to-consumer advertising to make older Americans aware of this vaccine's availability, uptake in 2014 was just 28%.

The journal Vaccine has published a study that examines 1 motivating factor that may prompt older Americans to seek out the zoster vaccine. The study, prepared by staff members from the CDC in Atlanta, GA, indicates that people who have close contact with someone who develops shingles—and see its pain and discomfort—are more likely to be vaccinated.

In this study, the researchers used a self-controlled case series and assessed herpes zoster vaccination rates among individuals whose spouses had developed shingles. The study design used pneumococcal vaccination rates as the control. The rationale was that if a spouse experienced shingles, individuals would not necessarily seek out a pneumococcal vaccination.

Study subjects included married couples who both were designated Medicare beneficiaries. They also had to be approximately the same age (within 5 years).

As expected, herpes zoster vaccination increased in the month after a spouse was treated for the shingles. The researchers did not see comparable increases in pneumococcal vaccination uptake.

The researchers also noted that the likelihood of vaccination for herpes zoster was directly related to the severity of the spouse's herpes zoster. When a spouse experienced a severe outbreak, individuals had a higher likelihood of being vaccinated.

This study indicates that seeing is believing. Individuals who saw the pain and suffering that herpes zoster caused in their spouses were 7 times more likely to be vaccinated in the month following the outbreak.

Of particular note, this finding is important because study indicates that individuals who have a family history of herpes zoster are more likely to develop herpes zoster.

One way to motivate patients to be vaccinated for herpes zoster is to ask patients if in the past, a family member has experienced this viral disease.

Reference

Harpaz R, Leung J. When zoster hits close to home: Impact of personal zoster awareness on zoster vaccine uptake in the United States. Vaccine. 2017 May 18. pii: S0264-410X(17)30573-X. doi: 10.1016/j.vaccine.2017.04.072. [Epub ahead of print]