Compared with the general population, rates of herpes zoster (HZ) reactivation tend to be much greater in hematologic and oncologic patients. The standardized incidence rate is 4.8 and 1.9, respectively, the researchers pointed out.
The inactivated varicella-zoster vaccine, Shingrix, has demonstrated effectiveness in inducing strong immune responses in that population, according to a recent study in Healthcare.
"Vaccinations have the potential to significantly lower the burden of disease for many major infections in the high-risk population of hematological and oncological patients," according to the German researchers. They pointed out that Shingrix received market approval in the European Union in March 2018, after prior U.S. approval in October 2017. The recommendations stated that the vaccine is for use in immunocompromised and oncologic patients, the researchers added.
The study noted that vaccination rates are considered to be poor in oncologic patients. The authors suggested that "determining the current vaccination rates for Shingrix 2 years after market approval is important in defining the need for intervention to bring this potentially high-impact vaccine to the patients."
To do that, they analyzed data from the Easy Vaccination in Oncology (EVO) Study to provide data for HZ vaccination rates in oncologic patients. The EVO Study was an interventional study evaluating the potential of increasing vaccination rates of specified must-have vaccinations by an instructional card in the oncologic setting.
For this study, data on 370 patients were analyzed—21.1% with hematologic malignancies and 78.9% with solid cancer. The results indicated that only 3.0% were vaccinated with Shingrix, although patients with hematologic malignancy were more likely to be vaccinated than those with solid cancer (7.7% vs. 1.7%).
"Despite clear recommendations and a pressing need in the high-risk population of hematological and oncological patients, the vast majority of patients are still left without vaccine protection against Herpes zoster by Shingrix," the researchers reported.
That is a problem, they noted, because "the impressive efficacy of about 97% for the general elderly population could not be replicated in real-world data for immunocompromised patients (64%), vaccination has the potential to significantly reduce disease burden and morbidity in this high-risk population."
They called the documented vaccination rates "disappointingly low" and posit that it represents a lack of awareness. The authors pointed out that all hematologic and oncologic patients in Germany who are aged 50 years and older are legally entitled to be vaccinated. "In this light, a vaccination rate close to none seems unacceptable in the year 2020, even more so as we were able to increase rates to 18% after only 3 months facilitating an offer to be vaccinated by a simple intervention, showing the potential to rapidly booster numbers," the authors wrote.
The highest vaccination rates in hematologic patients were 7.7% in multiple myeloma patients, which might indicate more awareness of higher HZ risk. "Multiple myeloma is with an incidence rate of 56/1,000 person-years known to be most at risk for HZ reactivation due to illness, but also treatment-related immunocompromising conditions," the researchers advised.
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