National trends and disparities in herpes zoster vaccination coverage among U.S. older adults with cancer, 2008-2023.

BACKGROUND

Immunocompromised conditions, including cancer, increase the risk of herpes zoster, a vaccine-preventable disease. However, evidence on vaccine uptake among patients with cancer is limited.

OBJECTIVES

This study aimed to (1) evaluate trends in herpes zoster vaccination and (2) identify factors associated with vaccination among U.S. older adults with cancer.

METHODS

Data were obtained from the 2008-2023 U.S. National Health Interview Survey. Joinpoint regression analysis was used to assess vaccination trends. A multivariable logistic regression model was used to identify factors associated with herpes zoster vaccination.

RESULTS

A total of 14,809 participants with cancer were included, representing approximately 5.6 million U.S. older adults with cancer. From 2008 to 2023, herpes zoster vaccination rates increased significantly among those with cancer (average annual percent change [AAPC] = 13.64; P < 0.01) and without cancer (AAPC = 14.20; P < 0.01), with consistently higher rates in the cancer group (P < 0.01). This upward trend persisted across all age groups for those with cancer. Disparities in vaccination were observed by age, sex, race/ethnicity, region, educational level, health insurance, income, flu vaccination, number of comorbidities, number of cancers, and years since cancer diagnosis.

CONCLUSIONS

Herpes zoster vaccination rates have surged among U.S. older adults with cancer over the past 16 years. However, significant disparities remain. Targeted interventions and supportive policies are critical to achieving equitable vaccine coverage in this at-risk population.