New CDC guidance highlights the importance of shingles vaccine, yet numbers suggest demand for it may be on decline.
Are we so focused on distribution of the COVID-19 vaccine that we have lost sight of the importance of inoculating against preventable diseases?
Data released recently by IQVIA indicates that may, in fact, be the case. According to these figures, demand for adult vaccines across all disease states has declined an average of more than 60% since the start of the pandemic in March 2020.
This includes decreases in the numbers of older adults vaccinated against shingles. About 11 of every 1000 adults over aged 70 years in the US developed shingles in 2016, the last year for which data are available. About 8 of every 1,000 adults aged 50 to 70 years is diagnosed with the disease.
Overall, approximately 1 in 3 people in the US will develop shingles in their lifetime. Notably, about 4% of older adults with shingles experience symptoms severe enough to require hospitalization.
The drop adult vaccination is probably not the result of lack of awareness of the importance of these shots to overall health—or a reflection of the growing influence of the “anti-vaxxer” movement. According to a recent survey conducted by The Harris Poll on behalf of GSK, makers of Shingrix, the vaccine recommended for preventing shingles and its complications in adults aged 50 years and older, 73% of adults ages 50 to 59 years believe it is “absolutely essential, extremely important, or very important” for people their age to get vaccinated.
Rather, it is likely due to reluctance on the part of older adults—who are at increased risk for severe COVID-19—to venture out for routine healthcare needs during the pandemic, for fear of being exposed to SARS-CoV-2. According to Fierce Pharma, in 2020, Shingrix brought in sales of $2.71 billion, or just 11% year-over-year growth from 2019 to 2020, after its sales more than doubled in 2019.
To address this potential downstream effect of the global health crisis, the US Centers for Disease Control and Prevention recently revised its guidance for Shingrix (GSK), the vaccine recommended for preventing shingles and its complications in adults aged 50 years and older. The new guidance reads: pharmacists: “Shingles vaccination is an essential preventive care service for older adults that should not be delayed or discontinued because of the COVID-19 pandemic, unless a patient is suspected or confirmed to have COVID-19. Healthcare providers and eligible patients should make every effort to ensure that 2 doses of Shingrix are administered within the recommended interval of 2 to 6 months.”
However, that second dose, which is essential for maximum protection, is also an issue. Data from the Kaiser Family Foundation (KFF) indicates that 26% of Medicare beneficiaries who received an initial dose of Shingrix between January and June of 2018 did not get the second dose within 6 months. KFF suggests that these findings may have implications for the COVID-19 vaccination effort, given that the two available products—from Pfizer-BioNTech and Moderna—both require 2 shots.
(Interestingly, there have been other links between shingles and COVID-19 in recent days. Posters on Reddit last week reported that they developed shingles within days of being vaccinated against SARS-CoV-2, and Google Trends data shows an uptick in searches on the topic over the past month or so. There is no data suggesting a risk for shingles following COVID-19 vaccination.)
The lesson? Older adults need to get vaccinated—against COVID-19 as well as other, preventable diseases. And it is incumbent upon the healthcare community to make that happen.