title: Factors associated with herpes zoster vaccination status and acceptance of vaccine recommendation in community pharmacies.
abstract: OBJECTIVE
  1. Identify patient characteristics, awareness and knowledge associated with herpes zoster (HZ) vaccination status. 2. Identify self-reported reasons for not receiving Zostavax(®). 3. Assess the impact of a patient education program by measuring post-intervention interest in obtaining the Zostavax(®) vaccine across reasons for being unvaccinated.
  
  
  METHODS
  A cross-sectional design with patients aged 60 years or older in 51 community pharmacies in Alabama and Florida was utilized. During the Introductory Pharmacy Practice Experience in summer 2013, 137 immunization-certified student pharmacists provided patient education on HZ and Zostavax(®) to unvaccinated patients using the Shingles Vaccine Information Statement. An interviewer-administered questionnaire assessed patient awareness of HZ, receipt of recommendations to receive Zostavax(®), and patient characteristics as well as vaccination status, reasons for being unvaccinated and interest in obtaining Zostavax(®) after the educational session.
  
  
  RESULTS
  A total of 681 patients participated in a conversation with a student pharmacist regarding their HZ vaccination status. The majority were female (57.6%), white (84.6%), and unvaccinated (73.6%). Results from logistic regression suggest that participants were more likely to be vaccinated if they received a recommendation from a healthcare provider (OR=5.15), received the influenza vaccine during the previous year (OR=3.56), or knew that Zostavax(®) was recommended for individuals over 60 years of age (OR=3.55). The most frequently provided reasons for being unvaccinated were "haven't gotten around to it/forgot" (27.2%) and "didn't know it was needed" (27.1%). After the educational session, the majority (72.5%) of unvaccinated patients were interested in speaking with their pharmacist or physician about receiving Zostavax(®). Analysis suggests that interest differed across initial reason for being unvaccinated (χ(2)=64.44; p<0.01).
  
  
  CONCLUSIONS
  Recommendations from healthcare providers are valued by patients and can improve vaccination rates. The patient education program increased interest in receiving Zostavax(®) and this interest differed depending on the reason provided for being unvaccinated.
authors.affiliation: Health Outcomes Research and Policy, Harrison School of Pharmacy, Auburn University, 020 James E. Foy Hall, Auburn, AL 36849, United States. Electronic address: teetebs@auburn.edu.
authors.forename: Benjamin S
authors.initials: BS
authors.lastname: Teeter
authors.affiliation: Health Outcomes Research and Policy, Harrison School of Pharmacy, Auburn University, 020 James E. Foy Hall, Auburn, AL 36849, United States. Electronic address: kbl0005@auburn.edu.
authors.forename: Kimberly B
authors.initials: KB
authors.lastname: Garza
authors.affiliation: Pharmacy Practice, Harrison School of Pharmacy, Auburn University, 1202 Walker Building, Auburn, AL 36849, United States. Electronic address: tls0002@auburn.edu.
authors.forename: T Lynn
authors.initials: TL
authors.lastname: Stevenson
authors.affiliation: Pharmacy Practice, Harrison School of Pharmacy, Auburn University, 1202 Walker Building, Auburn, AL 36849, United States. Electronic address: atkinmm@auburn.edu.
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Williamson
authors.affiliation: Harrison School of Pharmacy, Auburn University, 2316 Walker Building, Auburn, AL 36849, United States. Electronic address: mlz0001@auburn.edu.
authors.forename: Megan L
authors.initials: ML
authors.lastname: Zeek
authors.affiliation: Health Outcomes Research and Policy, Harrison School of Pharmacy, Auburn University, 020 James E. Foy Hall, Auburn, AL 36849, United States. Electronic address: westrsc@auburn.edu.
authors.forename: Salisa C
authors.initials: SC
authors.lastname: Westrick
mesh_terms: D000368:Aged; D000407:Alabama; D003157:Community Pharmacy Services; D003430:Cross-Sectional Studies; D005260:Female; D005431:Florida; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods*; D006562:Herpes Zoster / Q000517:prevention & control*; D053061:Herpes Zoster Vaccine / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic; D013339:Students, Pharmacy; D011795:Surveys and Questionnaires; D014611:Vaccination / Q000706:statistics & numerical data*
chemical_list: D053061:Herpes Zoster Vaccine
keywords: Education; Herpes zoster; Pharmacy; Shingles; Vaccination; Zostavax(®)