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Singer D, Sweeney C, Stempniewicz N, Reynolds M, Garbinsky D, Poston S. Knowledge, Attitudes, and Practices Regarding Herpes Zoster Vaccination Among Specialists. Popul Health Manag 2024. [PMID: 38838030 DOI: 10.1089/pop.2023.0284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2024] Open
Abstract
Recombinant zoster vaccine has been recommended by the US Advisory Committee on Immunization Practices (ACIP) for the prevention of herpes zoster (HZ) in immunocompetent adults aged at least 50 years since 2018. In January 2022, this was extended to immunodeficient/immunosuppressed adults aged at least 19 years. Key study objectives were to assess specialists' knowledge of the ACIP HZ vaccination recommendations, their attitudes toward HZ vaccination, and HZ vaccination practices/barriers. This cross-sectional, web-based survey (conducted in March 2022) included US dermatologists, gastroenterologists, infectious disease specialists, oncologists, and rheumatologists who treat patients with psoriasis, inflammatory bowel disease, human immunodeficiency syndrome, solid tumors/hematological malignancies, and rheumatoid arthritis, respectively. Although most of the 613 specialists correctly identified the ACIP HZ vaccination recommendations for adults aged at least 50 years (84%) and immunodeficient/immunosuppressed adults aged at least 19 years (67%), only 29% knew that recombinant zoster vaccine is recommended for individuals who have previously received zoster vaccine live, and only 18% knew all current ACIP recommendations. For patients with the diseases listed, 84% of specialists thought that HZ is a serious risk, 75% that HZ vaccination is extremely/very important, and 69% were extremely/very likely to recommend HZ vaccination. Only 36% administer vaccines themselves, mainly because patients receive vaccinations from others. Barriers to vaccination included more urgent/acute issues, insufficient time, and lack of patient motivation/willingness. Full knowledge of the ACIP HZ vaccination recommendations among the surveyed specialists was low. There may be a need to educate specialists to improve adherence to these recommendations. [Figure: see text].
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Affiliation(s)
- David Singer
- GSK, US Vaccines Health Economics and Outcomes Research, Philadelphia, Pennsylvania, USA
| | | | - Nikita Stempniewicz
- GSK, US Vaccines Health Economics and Outcomes Research, Philadelphia, Pennsylvania, USA
| | | | | | - Sara Poston
- GSK, US Vaccines Health Economics and Outcomes Research, Philadelphia, Pennsylvania, USA
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2
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Ciocca ET, Staggers KA, Carey J, Opekun AR, Hollinger FB, Keitel WA, Atmar RL, El Sahly HM, Whitaker JA. Delays in Hepatitis A vaccination in people with HIV in Houston, Texas between 2010 and 2018. Vaccine X 2024; 16:100422. [PMID: 38192618 PMCID: PMC10772366 DOI: 10.1016/j.jvacx.2023.100422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 11/30/2023] [Accepted: 12/11/2023] [Indexed: 01/10/2024] Open
Abstract
Background Studies have demonstrated low hepatitis A virus (HAV) vaccination rates among persons with HIV (PWH). Methods We conducted a retrospective study of persons entering HIV care at two clinics in Houston, Texas between 2010 and 2018. We defined those eligible for HAV vaccination as those who had no history of HAV vaccination and had a negative anti-HAV IgG at entry to care. Kaplan-Meier curves summarized time to receipt of HAV vaccines. The proportions of patients who received 1 and 2 HAV vaccines at 6, 12, and 24 months were estimated. Cox proportional hazards regression evaluated associations between patient characteristics and vaccination. Significant factors were included in a multivariable Cox proportional hazards model. Results Of 6,515 patients, 1372 were eligible for HAV vaccination. Of eligible patients, 29.2 % received 1 HAV vaccination at 6 months, 37.1 % at 12 months, and 47.8 % at 24 months. At 6 months, 10 % received 2 HAV vaccinations, 21.1 % at 12 months, and 33.4 % at 24 months. In multivariable analysis, men who have sex with men (adjusted HR 1.35, 95 % CI 1.06, 1.73) or those who had CD4 count ≥ 200 cells/µl (adjusted HR 2.52, 95 % CI 1.89, 3.37) had their second vaccination sooner than those who were not men who have sex with men or who had CD4 counts < 200 cells/µl, respectively. Patients > 50 years of age had their second vaccination sooner than those aged 30-50 years (adjusted HR 1.47, 95 % CI 1.08, 1.99). Those with active substance history had a longer time to second vaccination compared to those with no substance use history (adjusted HR 0.57, 95 % CI 0.40, 0.82). Conclusions HAV vaccination rates were low and highlight the need for effective solutions to address HAV immunization gaps in PWH, especially among young patients, those with active substance use disorders, and those with significant immunocompromise.
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Affiliation(s)
- Emily T. Ciocca
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Kristen A. Staggers
- Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, TX, USA
| | | | - Antone R. Opekun
- Department of Medicine, Section of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, TX, USA
| | - F. Blaine Hollinger
- Department of Medicine, Section of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, TX, USA
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA
| | - Wendy A. Keitel
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA
- Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX, USA
| | - Robert L. Atmar
- Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX, USA
| | - Hana M. El Sahly
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA
- Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX, USA
| | - Jennifer A. Whitaker
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA
- Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX, USA
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3
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Zou J, Krentz HB, Lang R, Beckthold B, Fonseca K, John Gill M. Sero-positivity, risks, and morbidity from Varicella-Zoster Virus (VZV) infections in an adult PWH (people with HIV) cohort from 2000-2020. Open Forum Infect Dis 2022; 9:ofac395. [PMID: 36004318 PMCID: PMC9394766 DOI: 10.1093/ofid/ofac395] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 08/08/2022] [Indexed: 11/13/2022] Open
Abstract
Background Varicella-zoster virus (VZV) infection disproportionately affects people with HIV (PWH), primarily presenting as herpes zoster. However, VZV seroprevalence, its association with zoster, and clinical outcomes remain understudied in era of modern antiretroviral therapy (ART). We assessed VZV seroprevalence, rates of VZV illness, and associated health care costs in a large cohort of PWH over 20 years. Methods We performed retrospective chart reviews of patients followed at a regional HIV clinic from January 1, 2000, to December 31, 2020. Serological, immunization, clinical, and costing data were extracted from in-house databases. VZV-related inpatient admissions, emergency department (ED), and urgent care (UC) visits were identified using relevant International Classification of Disease (ICD-10) codes and validated where possible by 2 physicians. Health care utilization costs were adjusted to 2020 Canadian dollars. Results Of 3006 PWH, VZV serology was available for 2628; of these, 2503 (95.2%) were seropositive. Only 39% of known seronegative patients were subsequently immunized for varicella. During 29 768 years of patient follow-up, 38 hospitalizations and 138 ED/UC visits due to VZV infection were identified. Most occurred in VZV-seropositive PWH <50 years of age (82%) who were unimmunized (99.2%) and not on ART (64.8%). Nearly 25% of hospitalizations were due to laboratory-confirmed VZV meningitis/encephalitis. The average admission cost was CDN$33 001; the total measured cost of VZV illness was CDN$1 258 718. Conclusions Despite ART and vaccines for chickenpox and shingles, VZV still caused significant costs and morbidity for PWH, occurring at younger ages and often as encephalitis/meningitis. Supporting ART adherence may reduce VZV illness and hospitalization costs in PWH, and the cost-effectiveness of expanding shingles vaccine use warrants further study.
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Affiliation(s)
- Jason Zou
- Department of Medicine, University of Calgary , Calgary, Alberta , Canada
| | - Hartmut B Krentz
- Department of Medicine, University of Calgary , Calgary, Alberta , Canada
- Southern Alberta Clinic, Alberta Health Services , Calgary, Alberta , Canada
| | - Raynell Lang
- Department of Medicine, University of Calgary , Calgary, Alberta , Canada
- Southern Alberta Clinic, Alberta Health Services , Calgary, Alberta , Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary , Calgary, Alberta Canada
| | - Brenda Beckthold
- Southern Alberta Clinic, Alberta Health Services , Calgary, Alberta , Canada
| | - Kevin Fonseca
- Alberta Precision Labs, ProvLab Calgary , Alberta , Canada
- Department of Microbiology, Immunology &Infectious Diseases, University of Calgary , Calgary, Alberta , Canada
| | - M John Gill
- Department of Medicine, University of Calgary , Calgary, Alberta , Canada
- Southern Alberta Clinic, Alberta Health Services , Calgary, Alberta , Canada
- Department of Microbiology, Immunology &Infectious Diseases, University of Calgary , Calgary, Alberta , Canada
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4
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Gerin L, Antonini M, Santos KDS, Gir E, Reis RK. O conhecimento dos profissionais de saúde sobre vacinação de pessoas vivendo com HIV – uma revisão integrativa. ESCOLA ANNA NERY 2022. [DOI: 10.1590/2177-9465-ean-2021-0210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivo Identificar evidências na literatura acerca do conhecimento dos profissionais de saúde sobre vacinação das pessoas vivendo com HIV. Método Trata-se de uma revisão integrativa. Para a busca, foram utilizados os descritores: pessoal de saúde (health personnel), conhecimento (knowledge), vacinação (vaccination), HIV e seus sinônimos, sem utilização de filtros, nas bases de dados Pubmed, Biblioteca Virtual em Saúde, Web of Science, Cumulative Index to Nursing and Allied Health Literature, Embase, Scopus, Science Direct e Cochrane. Foram incluídos apenas artigos primários analisados por meio do aplicativo RAYYAN. Resultados De 601 publicações iniciais, apenas cinco constituíram a amostra final, todas identificadas no Pubmed publicadas entre 2013 e 2018, sendo nenhum estudo brasileiro. A maioria das publicações estava relacionada a alguma vacina específica e não abordava todo o calendário vacinal. Conclusão e implicações para a prática O déficit de conhecimento dos profissionais de saúde, em relação às vacinas indicadas às pessoas vivendo com HIV, foi o principal aspecto identificado, resultando em insegurança dos profissionais. Há a necessidade de educação permanente das equipes multiprofissionais dos serviços especializados e da atenção primária visando diminuir as barreiras e aumentar a cobertura vacinal desta clientela.
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Affiliation(s)
- Larissa Gerin
- Secretaria Municipal de Saúde de Ribeirão Preto, Brasil; Universidade de São Paulo, Brasil
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5
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Johnson TM, Klepser DG, Bares SH, Scarsi KK. Predictors of vaccination rates in people living with HIV followed at a specialty care clinic. Hum Vaccin Immunother 2020; 17:791-796. [PMID: 32881642 DOI: 10.1080/21645515.2020.1802163] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
People Living with HIV (PLWH) remain disproportionately susceptible to vaccine-preventable illnesses due to increased morbidity and mortality from common pathogens, increased transmission related to epidemiologic factors, and decreased vaccination rates. We aimed to describe patient-specific predictive factors that may impact adherence to the CDC's recommended vaccination schedules in PLWH. We retrospectively evaluated adult PLWH in care at the University of Nebraska Medical Center's HIV clinic and collected information related to demographics, clinic visits, vaccination status, and measures of HIV disease control. Patients were categorized as "Adherent" if they had received all vaccinations for which they were eligible and were categorized as "Non-Adherent" if they were deficient or delayed in receiving one or more vaccinations. Participant characteristics were compared between groups by multivariable logistic regression to identify predictors associated with vaccine schedule non-adherence. We evaluated 502 PLWH who met our inclusion criteria; 206 of these (41%) had received all eligible vaccinations, while 296 (59%) were missing one or more vaccinations. The mean age of participants was 48 years old, 76% were male, and 53% were white. Our participants had a median of 2.83 clinic visits per year and missed 8.3% of scheduled clinic visits. Factors associated with non-adherence to vaccination schedules included a high frequency of missed clinic appointments (>10%), men who have sex with men, and a CD4 count <200 cells/mm3. Knowledge of variables associated with vaccination rates may be beneficial in identifying patients at-risk for under-vaccination and designing targeted education programs for providers and patients.
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Affiliation(s)
- Tanner M Johnson
- College of Pharmacy, Department of Pharmacy Practice and Science, University of Nebraska Medical Center, Omaha, NE, USA.,Department of Pharmacy, UCHealth University of Colorado Hospital, Aurora, CO, USA.,Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, USA
| | - Donald G Klepser
- College of Pharmacy, Department of Pharmacy Practice and Science, University of Nebraska Medical Center, Omaha, NE, USA
| | - Sara H Bares
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Kimberly K Scarsi
- College of Pharmacy, Department of Pharmacy Practice and Science, University of Nebraska Medical Center, Omaha, NE, USA.,Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
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Holloway IW, Wu ESC, Gildner J, Fenimore VL, Tan D, Randall L, Frew PM. Quadrivalent Meningococcal Vaccine Uptake Among Men Who Have Sex With Men During a Meningococcal Outbreak in Los Angeles County, California, 2016-2017. Public Health Rep 2019; 133:559-569. [PMID: 30188807 PMCID: PMC6134560 DOI: 10.1177/0033354918781085] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE The objective of our study was to assess meningococcal ACWY (MenACWY) vaccine uptake among men who have sex with men (MSM) during an ongoing, invasive meningococcal disease outbreak in Southern California. This research was important to inform future vaccination uptake interventions for this high-priority population. METHODS We conducted venue-based sampling to recruit and enroll MSM living in Los Angeles County, California, from December 2016 through February 2017. We conducted bivariate and multivariable analyses to evaluate associations between MenACWY vaccine uptake and other predetermined factors. RESULTS Of 368 participants, 138 (37.5%) reported receiving the MenACWY vaccine. In multivariable analyses, older age (adjusted odds ratio [aOR] = 2.57; 95% confidence interval [CI], 1.31-5.03), previous diagnosis of a sexually transmitted infection (aOR = 2.22; 95% CI, 1.14-4.30), belief that MenACWY vaccine is important (aOR = 3.49; 95% CI, 1.79-6.82), confidence in the MenACWY vaccine (aOR = 5.53; 95% CI, 3.11-9.83), and knowing someone who had been vaccinated (aOR = 5.82; 95% CI, 3.05-11.12) were significantly associated with MenACWY vaccine uptake. CONCLUSIONS Our findings reflect low uptake of the recommended MenACWY vaccine among MSM after a local outbreak, despite public health efforts. In addition to ongoing, widespread campaigns to inform MSM about local outbreaks and vaccination recommendations, MSM may be responsive to direct outreach from peers who have been vaccinated.
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Affiliation(s)
- Ian W. Holloway
- Luskin School of Public Affairs, University of California, Los Angeles, Los Angeles, CA, USA
| | - Elizabeth S. C. Wu
- Luskin School of Public Affairs, University of California, Los Angeles, Los Angeles, CA, USA
| | | | - Vincent L. Fenimore
- Luskin School of Public Affairs, University of California, Los Angeles, Los Angeles, CA, USA
| | - Diane Tan
- Luskin School of Public Affairs, University of California, Los Angeles, Los Angeles, CA, USA
| | - Laura Randall
- Division of Infectious Diseases, Department of Medicine, School of Medicine, Emory University, Atlanta, GA, USA
| | - Paula M. Frew
- Division of Infectious Diseases, Department of Medicine, School of Medicine, Emory University, Atlanta, GA, USA
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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Hawkins KL, Gordon KS, Levin MJ, Weinberg A, Battaglia C, Rodriguez-Barradas MC, Brown ST, Rimland D, Justice A, Tate J, Erlandson KM. Herpes Zoster and Herpes Zoster Vaccine Rates Among Adults Living With and Without HIV in the Veterans Aging Cohort Study. J Acquir Immune Defic Syndr 2018; 79:527-533. [PMID: 30179984 PMCID: PMC6203599 DOI: 10.1097/qai.0000000000001846] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Despite historically high rates of herpes zoster among people living with HIV (PLWH), comparative studies of herpes zoster by HIV serostatus are lacking since the advent of combination antiretroviral therapy and availability of zoster vaccine. METHODS Annual rates (2002-2015) of first-episode herpes zoster and zoster vaccination were calculated for PLWH and uninfected adults in the Veterans Aging Cohort Study and stratified by HIV serostatus and age. Herpes zoster was captured using ICD9 codes and vaccine receipt with procedural codes and pharmacy data. RESULTS Of 45,177 PLWH and 103,040 uninfected veterans, rates of herpes zoster decreased among PLWH (17.6-8.1/1000) over the study period but remained higher than uninfected adults (4.1/1000) at the end of study period. Rates were higher in PLWH with lower CD4 (<200 vs >500 cells/µL: 18.0 vs 6.8/1000) and unsuppressed vs suppressed HIV-1 RNA (21.8 vs 7.1/1000). Restricted to virologically suppressed participants with CD4 >350 cells per microliter, herpes zoster rates were similar among PLWH aged younger than 60 years and aged 60 years and older in 2015 (6.6 vs 6.7/1000) but higher than all uninfected age groups. At study end, cumulative receipt of zoster vaccine for PLWH aged 60 years and older was less than half that of uninfected veterans: 98.7 vs 215.2/1000. CONCLUSIONS Herpes zoster rates among PLWH have markedly decreased, but, even in cART-treated individuals, remain 50% higher than uninfected adults. Lower rates of zoster vaccine receipt combined with high rates of herpes zoster support the need for a safe and effective vaccine against herpes zoster for PLWH, formal zoster vaccine guidelines for PLWH, and consideration for expanded use at younger ages.
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Affiliation(s)
- Kellie L Hawkins
- Denver Public Health, Denver, CO
- Division of Infectious Diseases, Anschutz Medical Campus, University of Colorado, Aurora, CO
| | - Kirsha S Gordon
- Veterans Affairs Connecticut Healthcare System, West Haven, CT
- Yale University Schools of Medicine and Public Health, New Haven, CT
| | - Myron J Levin
- Division of Infectious Diseases, Anschutz Medical Campus, University of Colorado, Aurora, CO
| | - Adriana Weinberg
- Division of Infectious Diseases, Anschutz Medical Campus, University of Colorado, Aurora, CO
| | - Catherine Battaglia
- Division of Infectious Diseases, Anschutz Medical Campus, University of Colorado, Aurora, CO
| | - Maria C Rodriguez-Barradas
- Department of Medicine, Infectious Diseases Section, Michael E. DeBakey Veterans Affairs Medical Center, Baylor College of Medicine, Houston, TX
| | - Sheldon T Brown
- Department of Medicine, James J. Peters Veterans Affairs Medical Center, Mount Sinai School of Medicine, New York, NY
| | - David Rimland
- Division of Infectious Diseases, Atlanta Veterans Affairs Medical Center, Emory University School of Medicine, Atlanta, GA
| | - Amy Justice
- Veterans Affairs Connecticut Healthcare System, West Haven, CT
- Yale University Schools of Medicine and Public Health, New Haven, CT
| | - Janet Tate
- Veterans Affairs Connecticut Healthcare System, West Haven, CT
- Yale University Schools of Medicine and Public Health, New Haven, CT
| | - Kristine M Erlandson
- Division of Infectious Diseases, Anschutz Medical Campus, University of Colorado, Aurora, CO
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Geretti AM, Brook G, Cameron C, Chadwick D, French N, Heyderman R, Ho A, Hunter M, Ladhani S, Lawton M, MacMahon E, McSorley J, Pozniak A, Rodger A. British HIV Association Guidelines on the Use of Vaccines in HIV-Positive Adults 2015. HIV Med 2018; 17 Suppl 3:s2-s81. [PMID: 27568789 DOI: 10.1111/hiv.12424] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Anna Maria Geretti
- Institute of Infection and Global Health, University of Liverpool, Liverpool, UK
| | | | | | | | | | | | | | | | | | - Mark Lawton
- Royal Liverpool University Hospital, Liverpool, UK
| | - Eithne MacMahon
- Guy's & St Thomas' NHS Foundation Trust, London, UK.,King's College London, London, UK
| | | | - Anton Pozniak
- Chelsea and Westminster Hospital, NHS Foundation Trust, London, UK
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Erlandson KM, Streifel A, Novin AR, Hawkins KL, Foster C, Langness J, Bessesen M, Falutz J, Moanna A, Looney D, Johns ST, Nguyen JB, Oxman MN, Levin MJ. Low Rates of Vaccination for Herpes Zoster in Older People Living With HIV. AIDS Res Hum Retroviruses 2018; 34:603-606. [PMID: 29661022 DOI: 10.1089/aid.2017.0315] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Herpes zoster (HZ) occurs at a higher age-specific rate in people living with HIV (PLWH) than in the general population. We implemented a quality improvement study to assess herpes zoster vaccine (HZV) usage among PLWH, assess HZV usage after additional reminders/prompts, and identify barriers to HZV among older PLWH. HZV rates in PLWH were determined in six institutions with varying payment structures. For the intervention, Part 1, PLWH eligible for HZV at the University of Colorado were identified, and providers were notified of patient eligibility. In Part 2, in addition to provider notification, an order for HZV was placed in the patient's chart before a clinic appointment. HZ vaccination rates ranged from 1.5% to 42.4% at six sites. Before the intervention, 21.3% of eligible University of Colorado patients had received HZV. An additional 8.3% received HZV with Part 1 and 17.8% with Part 2 interventions. At completion, a total of 53.2% of eligible patients had received HZV through routine clinical care or the interventions. Insurance coverage concern was cited as a common reason for not receiving HZV. Minor adverse reactions occurred in 26.7% patients and did not require medical care. HZV coverage was low at a majority of sites. Clinical reminders with links to vaccination orders or preplaced vaccination orders led to improved HZV coverage in our clinic, but published guidelines for use of HZV in PLWH and improvement in logistic or insurance barriers to HZV receipt are paramount to improved HZV coverage.
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Affiliation(s)
- Kristine M. Erlandson
- Division of Infectious Diseases, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Amber Streifel
- Skagg's School of Pharmacy, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Alexander R. Novin
- Skagg's School of Pharmacy, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Kellie L. Hawkins
- Division of Infectious Diseases, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
- Division of Infectious Diseases, Department of Medicine, Denver Health Medical Center, Denver, Colorado
| | - Clayton Foster
- Division of Infectious Diseases, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Jacob Langness
- Skagg's School of Pharmacy, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Mary Bessesen
- Division of Infectious Diseases, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
- Department of Veterans Affairs Eastern Colorado Healthcare System, Denver, Colorado
| | - Julian Falutz
- Department of Medicine, McGill University, Montreal, Canada
| | - Abeer Moanna
- Atlanta Veteran's Administration Healthcare System, Atlanta, Georgia
- Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia
| | - David Looney
- Medicine Service, Infectious Diseases Section (111F), VA San Diego Healthcare System, San Diego, California
- Division of Infectious Diseases, Department of Medicine, University of California, San Diego, San Diego, California
| | - Scott T. Johns
- VA San Diego Healthcare System, Pharmacy Service (119), San Diego, California
| | - Joseph B. Nguyen
- VA San Diego Healthcare System, Pharmacy Service (119), San Diego, California
| | - Michael N. Oxman
- Medicine Service, Infectious Diseases Section (111F), VA San Diego Healthcare System, San Diego, California
- Division of Infectious Diseases, Department of Medicine, University of California, San Diego, San Diego, California
| | - Myron J. Levin
- Section of Infectious Diseases, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado
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10
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Crum-Cianflone NF, Sullivan E. Vaccinations for the HIV-Infected Adult: A Review of the Current Recommendations, Part II. Infect Dis Ther 2017; 6:333-361. [PMID: 28780736 PMCID: PMC5595779 DOI: 10.1007/s40121-017-0165-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Indexed: 12/14/2022] Open
Abstract
Vaccination is a critical component for ensuring the ongoing health HIV-infected adults. Since this group may have reduced immune responses and shorter durations of protection post-vaccination, HIV-specific guidelines have been published. This review article provides a comprehensive discussion of the current guidelines and evidence-based data for vaccinating HIV-infected adults, including data on dosing schedules, immunogenicity studies, and safety. In the current paper, part II of the review, live vaccines, as well as vaccines for travelers and specific occupational groups, will be discussed.
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Affiliation(s)
- Nancy F Crum-Cianflone
- Internal Medicine Department, Scripps Mercy Hospital, San Diego, CA, USA.
- Infectious Disease Division, Scripps Mercy Hospital, San Diego, CA, USA.
- Infectious Disease Division, Naval Medical Center San Diego, San Diego, CA, USA.
| | - Eva Sullivan
- Pharmacy Department, Scripps Mercy Hospital, San Diego, CA, USA
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11
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Blackwell CW. Knowledge of Vaccination Needs of HIV-Infected Men Who Have Sex with Men in a National Sample of "Gay Friendly" Health care Providers. Public Health Nurs 2016; 33:403-11. [PMID: 26847956 DOI: 10.1111/phn.12250] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The purpose of this study was to assess knowledge levels regarding vaccination needs of healthy, HIV-infected (with CD4 counts >200 cells/mm(3) ) men who have sex with men (MSM) in a national sample of "gay friendly" health providers. DESIGN AND SAMPLE Participants (n = 92) were sent a demographic questionnaire and case vignette asking for correct identification of vaccine needs of an HIV-infected MSM with a CD4 count >200 cells/mm(3) . Participants were recruited from the Gay and Lesbian Medical Association's Health Provider Index. MEASURES Descriptive statistics and Fisher's exact test were used to answer the research questions and define the sample. RESULTS The vast majority of the sample (n = 83; 90%) misidentified correct vaccine needs of and/or selected inappropriate vaccines for the HIV-infected MSM. Greater familiarity with the CDC Adult Vaccination Schedule (p = .027), practice specialization (p = .004), and administration of vaccinations within location of practice (p = .009) were associated with greater knowledge of the patient's vaccine needs. CONCLUSIONS Health care providers who prescribe vaccines to HIV-infected MSM need more education regarding their vaccine needs. Nurses can reduce disparities in HIV-infected MSM by advocating for vaccination and augmenting providers' comprehension of vaccine needs of this population.
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