Purpose <p>To estimate recombinant zoster vaccine (RZV) use among adults with cancer since the 2021 US Advisory Committee on Immunization Practices (ACIP) recommendation to vaccinate immunocompromised adults aged ≥ 19 years and gather insights into oncologist practices, perceptions, barriers, and facilitators to RZV vaccination among adults with cancer.</p> Methods <p>In this retrospective cohort study, RZV uptake (≥ 1 dose) and completion (2 doses) were assessed among RZV-naïve, immunocompromised patients aged ≥ 19 years with a solid tumor cancer or hematologic malignancy using IQVIA’s open medical and prescription claims. Patients were followed from the ACIP voting date (October 20, 2021) until June 30, 2023. RZV uptake, series completion, time to completion, and dosing schedule compliance were described. Generalized estimation equation models assessed factors associated with uptake. Fifteen oncologists were interviewed regarding their RZV practices, perceptions, barriers, and facilitators, and themes were generated based on responses.</p> Results <p>Among 388,923 and 277,314 RZV-naïve patients with a solid tumor cancer or hematologic malignancy, cumulative RZV uptake increased gradually, reaching 7.6% and 8.6%, respectively. Series completion rates at 6 and 12 months among those who initiated RZV were 63.2% and 70.9% in the solid tumor cancer cohort and 64.7% and 71.6% in the hematologic malignancy cohort. The odds of RZV uptake varied by cancer type and tended to increase with age and household income. Oncologists reported that they primarily serve an advisory role in vaccination due to workflow and financial challenges and competing patient needs, opting instead to delegate this responsibility to primary care providers and pharmacists.</p> Conclusion <p>RZV uptake among RZV-naïve immunocompromised patients with cancers has been slow and suboptimal since the 2021 ACIP recommendation, but series completion is likely once initiated.</p> Graphical Abstract <p></p>

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Recombinant zoster vaccine uptake and series completion among immunocompromised adults with cancer in the US

  • Justin Gatwood,
  • Catherine McGuiness,
  • Vasudha Gupta,
  • Marie Yasuda,
  • Chi-Chang Chen,
  • Nikita Stempniewicz

摘要

Purpose

To estimate recombinant zoster vaccine (RZV) use among adults with cancer since the 2021 US Advisory Committee on Immunization Practices (ACIP) recommendation to vaccinate immunocompromised adults aged ≥ 19 years and gather insights into oncologist practices, perceptions, barriers, and facilitators to RZV vaccination among adults with cancer.

Methods

In this retrospective cohort study, RZV uptake (≥ 1 dose) and completion (2 doses) were assessed among RZV-naïve, immunocompromised patients aged ≥ 19 years with a solid tumor cancer or hematologic malignancy using IQVIA’s open medical and prescription claims. Patients were followed from the ACIP voting date (October 20, 2021) until June 30, 2023. RZV uptake, series completion, time to completion, and dosing schedule compliance were described. Generalized estimation equation models assessed factors associated with uptake. Fifteen oncologists were interviewed regarding their RZV practices, perceptions, barriers, and facilitators, and themes were generated based on responses.

Results

Among 388,923 and 277,314 RZV-naïve patients with a solid tumor cancer or hematologic malignancy, cumulative RZV uptake increased gradually, reaching 7.6% and 8.6%, respectively. Series completion rates at 6 and 12 months among those who initiated RZV were 63.2% and 70.9% in the solid tumor cancer cohort and 64.7% and 71.6% in the hematologic malignancy cohort. The odds of RZV uptake varied by cancer type and tended to increase with age and household income. Oncologists reported that they primarily serve an advisory role in vaccination due to workflow and financial challenges and competing patient needs, opting instead to delegate this responsibility to primary care providers and pharmacists.

Conclusion

RZV uptake among RZV-naïve immunocompromised patients with cancers has been slow and suboptimal since the 2021 ACIP recommendation, but series completion is likely once initiated.

Graphical Abstract