Significant Gaps in Herpes Zoster Vaccination Coverage

Recent statistics reveal that only 20% of eligible individuals in Germany have received vaccination against herpes zoster, commonly known as shingles. This alarming figure was presented by a leading representative of the Barmer health insurance company during a recent report launch in Berlin.

Despite the vaccination being covered by health insurance since May 2019, approximately 80% of those eligible, particularly individuals aged 60 and older, remain either unvaccinated or only partially vaccinated, affecting around 20 million people nationwide.

The approved inactivated vaccine, Shingrix®, requires two doses for optimal effectiveness. Health officials confirm that the vaccine significantly reduces the incidence of shingles, preventing two-thirds of potential cases, as highlighted in the latest pharmaceutical report. The data indicates a stark contrast in shingles incidence between vaccinated and unvaccinated individuals, with 11.4 cases per 1,000 among the unvaccinated compared to just 4.1 cases per 1,000 among those who have been vaccinated.

Shingles is a reactivation of the varicella-zoster virus, the same virus that causes chickenpox, and is characterized by a painful, strip-like rash. This condition can lead to prolonged nerve pain known as postherpetic neuralgia, and in severe cases, can cause blindness if the eyes are affected. The prevalence of shingles is notably high, and the risk of complications escalates with age, particularly among seniors.

However, vaccination rates among older adults are particularly concerning. For instance, the immunization rate for those aged over 80 is around 19.7%, and it drops to 15.5% for individuals over 85.

The reasons for these suboptimal vaccination rates are complex. While some might attribute it to vaccine hesitancy, health experts suggest that organizational issues within medical practices play a significant role. The herpes zoster vaccine was relatively new at the onset of the COVID-19 pandemic, and although there was a temporary increase in vaccination rates during that period, they have since declined.

Analyses of general practitioner practices that cater to at least 50 eligible patients reveal considerable disparities in vaccination rates across different locations. Some practices have not administered the shingles vaccine at all, and only 5% have successfully vaccinated half of their eligible patients. In contrast, one practice recorded a vaccination rate as high as 88%.

This inconsistency raises concerns about patient access to vital health information and services. It is imperative for patients to be informed about vaccination options as part of their healthcare rights.

To enhance vaccination rates and mitigate the incidence of shingles and its complications, experts recommend implementing reminder systems for both patients and doctors. Some initiatives have already been initiated by the Barmer health insurance provider. Furthermore, the introduction of electronic patient records is anticipated to facilitate improvements in this area.

Regular checks of vaccination status during routine health assessments for seniors should also become standard practice. The low vaccination rates in various practices are often linked to organizational challenges and the prioritization of urgent medical diagnoses over preventive measures. Therefore, training programs for healthcare providers should emphasize the importance of integrating vaccination services into everyday practice.

While some advocate for allowing pharmacies to administer vaccinations as a means to increase coverage, health officials assert that vaccination remains a medical responsibility. However, evidence from Australia, where pharmacists have been permitted to administer vaccines for several diseases, including shingles, indicates that such measures can lead to increased vaccination rates.