Abstract
PURPOSE: To evaluate trends and disparities in herpes zoster vaccination among US older adults with diabetes. METHODS: Data from the 2008 to 2023 National Health Interview Survey were used. Joinpoint regression analysis was performed to analyze trends in herpes zoster vaccination. A multivariable logistic regression model was used to identify factors associated with herpes zoster vaccination. RESULTS: A total of 42 377 participants with diabetes were included, representing approximately 18 million US older adults with diabetes. From 2008 to 2023, the prevalence of herpes zoster vaccination increased nearly tenfold, from 4.2% in 2008 to 42.2% in 2023 (average annual percent change = 14.09, p < 0.01), with similar overall trends observed in adults without diabetes (p = 0.08). Upward trends were also observed across age groups and diabetes types. Several factors, including age, race/ethnicity, region, educational level, health insurance, income, perceived health status, flu and pneumococcal vaccination, comorbid atherosclerotic cardiovascular disease and cancer, were associated with herpes zoster vaccination. CONCLUSION: Herpes zoster vaccine coverage has surged among US older adults with diabetes over the past 16 years. However, disparities in vaccination remain, underscoring the need for targeted policies and interventions to improve coverage.