Abstract
BACKGROUND: Despite broad recommendations in older adults, uptake for the 2-dose recombinant zoster vaccine (RZV), which protects against herpes zoster (ie, shingles), has historically been low in the United States among those aged 50 years and older. By recommending RZV, health care providers play a critical role in encouraging shingles prevention among older adults. A vaccine prescription may reinforce a recommendation, but understanding the extent and associated characteristics of uptake following prescription is needed. OBJECTIVE: To describe RZV uptake following an RZV prescription among US adults aged 50 years and older. METHODS: RZV uptake following a prescription among adults aged 50 years and older in the United States was assessed from 2017 to 2023 using administrative claims data linked with electronic health records. Patient demographic and clinical characteristics, provider characteristics, and health system factors were presented descriptively and compared between those with and without RZV administration following a prescription. A Cox proportional hazards model assessed associations between patient, provider, and health system factors and RZV administration following an RZV prescription. RESULTS: Of the 8,715 patients with an RZV prescription included, vaccine uptake following prescription was generally high: 71% of patients received at least 1 RZV dose following prescription, of which 82% were administered in a pharmacy setting. Among prescriptions with a known provider specialty source, 91% were written by primary care physicians or internal medicine providers. Factors such as Medicare Advantage with Part D coverage (vs commercial insurance), household income of at least $75,000 (vs <$40,000), and having an immunocompromising or autoimmune condition were associated with higher rates of RZV administration following a prescription. CONCLUSIONS: Receipt of RZV is likely following a healthcare provider's recommendation, as shown by the high uptake observed among adults who received RZV prescriptions in this study. Additional efforts are needed to ensure full adherence with provider recommendations for herpes zoster prevention.