For patients with COPD, the risk of developing HZ ranges from 50% to more than 200% higher than those without the diagnosis. Yet, a new study finds that those risks are not well known among COPD patients.

HZ—commonly called shingles—is more common with immunosuppression in general, according to the report in Vaccines. Researchers from the COPD Foundation and colleagues reported that awareness of that is surprisingly low among patients, however, and vaccine uptake is low.

To reach that conclusion, the study team conducted the Shingles Patient Prevention Study. Their primary objective was to assess the Advisory Committee on Infection Practices (ACIP)-preferred HZ vaccine use and the barriers to vaccination among people with COPD. A secondary objective was to quantify knowledge, beliefs, and attitudes regarding HZ and its burden among people with COPD.

Researchers assessed the impact of a 5-minute educational video on the awareness of the HZ risks associated with COPD. They also gauged interest in future HZ vaccination among participants who reported not having already completed ACIP-preferred HZ vaccinations.

Participants included U.S. members of the COPD Foundation's Patient-Powered Research Network aged 50 years and older who were surveyed in fall 2020. Responses were analyzed using descriptive and comparative statistics.

Results indicated that of the 735 respondents (59.6% female, mean age 68.5 years), 192 (26.1%) reported previous HZ. About a fourth (25.5%) reported increased COPD symptoms during HZ episodes.

The authors advised that most participants (94.0%) knew of HZ vaccines, although only 33.1% reported receiving the recombinant HZ vaccination, which is preferred by ACIP. Whether the patients recalled receiving HZ vaccine recommendations differed by healthcare provider: 68.8% primary care and 26.6% pulmonology offices.

Most respondents (74.7%) were unaware that COPD increases HZ risk, and the authors reported, "Among unvaccinated participants, interest in getting the HZ vaccine increased from 32.0% to 73.5% after watching the video. These results highlight the need for people with COPD to receive further HZ education, such as the 5-minute video, and HZ vaccine recommendations from healthcare professionals."

A study published by Chronic Obstructive Pulmonary Disease last year determined that healthcare-resource utilization and cost burden is higher in patients with COPD with versus without HZ. "These results could help to estimate the potential cost benefits of HZ vaccination among patients with COPD," wrote industry authors.

The retrospective, cohort study of adults aged 50 years and older in the U.S. used administrative claims data from Optum's deidentified Clinformatics Data Mart Database for commercially insured and Medicare Advantage members (2013-2018). Researchers identified two cohorts of patients with COPDÐ3,415 with HZ (COPD+/HZ+) and 35,360 without HZ (COPD+/HZ-).

The study team compared all-cause and COPD-related HRU rates and costs (2018 U.S. dollars) between cohorts for up to 12 months of follow-up.

Results indicated that patients in the COPD+/HZ+ versus COPD+/HZ- cohort had increased use of all-cause (adjusted incidence rate ratio [aIRR] 1.17; 95% CI 1.14, 1.21) and COPD-related (aIRR 1.27; 95% CI 1.21, 1.34) medical services (both P <.001) and higher mean total all-cause ($4,140 vs. $3,749 per person per month [PPPM]; adjusted cost difference +$313 PPPM) and COPD-related ($1,541 vs. $1,231 PPPM; +$152 PPPM) costs (both P <.004) in the year after HZ.

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