| Abstract |
Introduction
Herpes Zoster (HZ or shingles) is a disease caused by the reactivation of the varicella zoster virus. Shingles can occur anywhere on the body but it typically looks like a single stripe of blisters that wraps around the left side or the right side of the torso. Despite the fact that HZ is rarely lethal, it poses a public health burden since 20-30% of all persons will develop it during their lifetimes. There are two available vaccines against HZ at the moment. Zostavax (ZVL, Merck) which is a live attenuated vaccine and Shingrix (RZV, GlaxoSmithKline) which is a recombinant subunit vaccine. Despite the availability of vaccines against HZ, the reported rate of vaccination in Greece is relatively low (~20%). This study aims to estimate the rate of vaccination against HZ amongst eligible (for vaccination) Primary Care (PC) visitors and investigate the determinants associated with vaccination.
Methods
A cross-sectional study took place between October and December 2022. The setting included two public PC units located in the Heraklion District, namely the 4th Local Health Unit in the city of Heraklion (the capital of the district) and the Health Center of Agia Varvara which is located in a rural area of the district. Eligible participants were visitors of the selected PC units aged between 60-75 years according to the recommendations of the National Program for adult Vaccination against HZ. All data were collected via anonymous questionnaires and elicited information regarding the basic demographics, health habits, somatometric information and the chronic illnesses of the population. The (adjusted for HZ) Health Belief Model questionnaire was used in order to assess the beliefs of participants for HZ and related vaccines. Four hundred individuals participated in the study, half of them (n=200) from the Local Health Unit of Heraklion and half (n=200) from Agia Varvara Health Center. Most of them were women (58.5%) and their mean age was 68.1 (±4.9) years. Most frequent chronic illnesses were the diseases of the circulatory system (75.3%), followed by endocrine, metabolic and nutritional diseases (40.5%) and musculoskeletal and connective tissue diseases (28.2%). Fifty-nine individuals (14.8%) reported having been sick from shingles, while 147 (36.8%) reported being vaccinated against HZ. Almost half of them reported receiving a recommendation for vaccination by their doctor (54.8%) or a health care professional (55.3%). Vaccinated (against HZ) participants were significantly older compared to non-vaccinated (p=0.001). Those who suffered from respiratory illnesses were vaccinated at a significantly higher rate against those who did not suffer from respiratory illnesses (52.0% versus 34.6%, p=0.017). Vaccinated individuals reported a higher perceived severity and susceptibility of the disease (p=0.002), higher perceived benefits from vaccination (p<0.0001) and higher cues for action (p<0.0001) compared to the non-vaccinated individuals. On the contrary, non-vaccinated (against HZ) individuals reported significantly higher perceived barriers compared to vaccinated peers (p<0.0001).
The perceived severity and susceptibility of the disease (OR 1.057; p=0.001), the perceived benefits from vaccination (ΟR 1.327; p<0.0001) and the cues for action (OR 2.601; p<0.0001) were associated with increased odds for vaccination against HZ. On the other hand, the perceived barriers were associated with reduced odds for vaccination against HZ (OR 0.845; p<0.0001).
Conclusions
The present study reported a higher vaccination rate against HZ (36.8%) from what is reported in literature for Greece (20.0%). Additionally, this work highlighted some significant determinants which influenced positively or negatively the vaccination status of participants, with the most important being the cues for action by their doctors or health care professionals.
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Ο Εμβολιασμός έναντι του Έρπητα Ζωστήρα στην Πρωτοβάθμια Φροντίδα Υγείας . : Ποσοστά και προσδιοριστές εμβολιασμού
