Table 4.

Overview of real-world evidence investigating series completion rate for the recombinant zoster vaccine^a.

Publication	Study type/period	Population	Two-dose series completion rate
Patients aged ≥ 50 years
Patterson et al. Hum Vaccin Immunother 202155b and Patterson et al. J Am Pharm Assoc 202256c	Retrospective study of IQVIA prescription claims and medical claims datasets, USA Oct 2017–Sep 2019	Aged ≥ 50 years (N = 7,097,441)	Second dose within 60 days: 3%55 Second dose within 90 days: 36%55 Second dose within 2–6 months: 67.6%56 Second dose within 6 months: 70.4%56 Second dose within 12 months: 81.8%56
McGirr et al. Vaccine 202157	Retrospective study of IQVIA prescription database, Canada Jan 2017–May 2019	Aged ≥ 50 years (6-months’ follow-up: N = 155,747; 12-months’ follow-up: N = 55,524)	6-month follow-up cohort: Second dose within 2–6 months: 65.0% 12-month follow-up cohort: Second dose within 2–6 months: 66.8% Second dose within 2–12 months: 74.9%
Izurieta et al. Clin Infect Dis 202119	Cohort study using Medicare claims and enrollment database analysis, USA Nov 2017–Oct 2019	Aged ≥ 65 years (N = 1,006,446)	Second dose within 6 months: 78% Second dose within 12 months: 86%
LaMori et al. Vaccine 202258	Retrospective study using EHR data from Optum Clinformatics Data Mart, USA Apr 2017–Mar 2021	Aged ≥ 50 years (N = 726,352)	Second dose within 2–6 months: 71.8% Second dose within 6 months: 72.3% Second dose within 24 months: 86.2%
Leung et al. Vaccine 202262	Retrospective study of IQVIA PharMetrics Plus and IBM MarketScan databases, USA Apr 2017–Dec 2021	Aged 50–64 years (IQVIA 6-month follow-up: N = 1,106,956; MarketScan 6-month follow-up: N = 788,831; IQVIA 12-month follow-up: N = 868,619; MarketScan 12-month follow-up: N = 594,987)d	IQVIA 6-month follow-up cohort: 67% (median dose interval: 89 days) MarketScan 6-month follow-up cohort: 71% (median dose interval: 90 days) IQVIA 12-month follow-up cohort: 78% MarketScan 12-month follow-up cohort: 82%
Gatwood et al. Am J Prev Med 202259	Prospective quality improvement program conducted at a US pharmacy chain Nov 2018–2021	Aged ≥ 50 years (N = 113,441)	Without clinical nudge: 71.9% (mean days to completion: 109.8)e With clinical nudge: 75.2% (mean days to completion: 93.3)e
Gatwood et al. Vaccine 202361f	Prospective quality improvement program conducted at a US pharmacy chain Jan 2019–Mar 2020	Aged ≥ 50 years (N = 220,966)	Prior to text messagingg being launched:h 83.9% (mean days to completion: 88.6) After text messaging being launched: With text message: 88.3% (mean days to completion: 86.2) Without text message: 85.3% (mean days to completion: 94.4)
Ackerson et al. Vaccine 202137	Retrospective cohort study using EHR data from Kaiser Permanente Southern California, USA Apr 2018–Nov 2018	Aged ≥ 50 years (N = 31,120)	Second dose within 9 months: 67.2%
Fix et al. Vaccine 202363	Retrospective cohort study of IBM MarketScan database, USA Jan 2018−Dec 2019	Aged 50−64 years (N = 4,678,729)	Second dose within 6 months: 88.6% (average dose interval: 3.7 months) Second dose within study period: 89.5%
Special patient populations
Gupta et al. J Clin Rheumatol 202245	Medical records review using University of Texas Southwestern Medical Center EHR data, USA Jan 2018–Mar 2020	Aged ≥ 18 years with established rheumatic disease (N = 65)	52.3%a
Leung et al. Arthritis Rheumatol 202241	Self-controlled case-series analysis using claims data from IBM MarketScan, USA (2017–2019) and Centers for Medicare and Medicaid Services Medicare databases, USA (2017–2020)	Aged ≥ 50 years with immune-mediated inflammatory disorders (N = 216,199)	Aged 50–64 years: 76.6% (median dose interval: 100 days) Aged ≥ 65 years: 85.4% (median dose interval: 98 days)
Satyam et al. Dig Dis Sci 202039	Prospective, observational, single-center study at Boston Medical Center, USA Feb 2018–Jul 2019	Patients with IBD (N = 67)	82%a
Barghash et al. J Heart Lung Transplant 202038	Retrospective single-center study, USA Sept 2018–June 2020	Adults who had previously received a heart transplant (N = 65)	70.8% (average dose interval: 4.6 months)
Porter et al. J Am Pharm Assoc 202160	Retrospective cohort study in an HIV/infectious disease clinic Jul 2018–Dec 2018	HIV-positive patients aged ≥ 50 years, without immunocompromise (N = 119) Pharmacist-directed pilot program (n = 35) Usual HZ education (n = 84)	Pharmacist-driven RZV administration program: 66% (p < .001 vs. standard care) Standard care: 23%

^aNo timescale reported.

^bPaper described the same study as in footnote c and evaluated cumulative RZV uptake, second-dose completion levels, and adherence to dosing recommendations in the US.

^cPaper evaluated completion rates and adherence in the overall US adult population aged ≥ 50 years and in subpopulations of interest (e.g., immunocompromised individuals, African Americans), and evaluated factors affecting completion rates and adherence.

^dSome individuals were included in both the 6-month and 12-month cohorts, but the cohorts do not completely overlap because of different enrollment requirements described in the study.

^eClinical nudge consisted of an alert triggered ≥ 8 weeks after the initial RZV dose and a prompt to proactively contact such patients. The alert appeared in the pharmacy electronic dashboard each time eligible patients visited the pharmacy until either the second dose was given or 6 months after the first dose had passed.

^fPaper described the second phase of the program first implemented in November 2018 and described in Gatwood et al. Am J Prev Med 2022.⁵⁹ The second phase included additional initiatives (text messaging) that were launched on September 18, 2019.

^gPatients received a text message ≥ 8 weeks after the initial RZV dose in addition to the clinical nudge described in footnote e. Messages were sent once monthly until either the second dose was given or 6 months after the first dose had passed.

^hWith clinical nudge in place, as described in footnote e.

EHR, electronic health record; HIV, human immunodeficiency virus; HZ, herpes zoster; IBD, inflammatory bowel disease; RZV, recombinant zoster vaccine.