Co-administration of recombinant zoster vaccine with other recommended vaccines among older adults in the United States of America.

Abstract

Co-administration of most adult vaccines is recommended to increase uptake, including recombinant zoster vaccine (RZV), which is recommended for all adults aged ≥50 years in the United States. This retrospective study used administrative claims data from the Optum Research Database for patients aged ≥50 years. Patients with ≥1 claim for RZV during 2017-2023 were divided into two cohorts based on whether their first RZV dose was co-administered with influenza, pneumococcal, and/or tetanus-diphtheria/tetanus-diphtheria-acellular pertussis vaccines. Geospatial analysis visualized co-administration at county and zip code levels. Multivariable logistic regression compared characteristics across cohorts and assessed relationships between co-administration and other factors with RZV series completion and dosing schedule adherence. RZV was co-administered in 24.2% of 1,622,250 patients who received RZV and was most common with influenza vaccine (65.1%), peaking in fall each year. Geospatial analysis revealed the lowest levels of co-administration in the Northeast. Logistic regression identified age ≥ 70 years, Asian race, higher education and household income, fewer comorbidities, and administration in a pharmacy as associated with lower odds of RZV co-administration. RZV co-administration was associated with lower odds of series completion and dosing schedule adherence. Opportunities exist to increase co-administration of RZV with other recommended vaccines.