Recombinant Zoster Vaccine Uptake in Patients with Noninfectious Ocular Inflammatory Diseases Receiving...

The recombinant zoster vaccine is recommended for adults 19 years or older who are immunodeficient or immunosuppressed. However, vaccine uptake in patients with noninfectious ocular inflammatory diseases (NOID) receiving immunosuppressive therapy remains unclear.

Retrospective cohort study using a de-identified electronic health record platform (TriNetX).

Adults aged 19-49 with NOID receiving short-term (< 1 year) or long-term (≥ 1 year) immunosuppressive therapy were compared with adults aged ≥ 50 years with NOID receiving comparable immunosuppressive therapy after 1:1 propensity score matching. All patients had an index event occurring on or after July 23^rd, 2021.

Recombinant zoster vaccine uptake following NOID diagnosis and initiation of immunosuppressive therapy was evaluated using Cox proportional hazards models. Propensity score matching was performed using demographic and clinical comorbidities. Influenza vaccine uptake was additionally evaluated as a comparative measure of general vaccine utilization behavior.

Hazard ratios (HR) for recombinant zoster vaccine uptake and influenza vaccine uptake.

Compared with adults aged ≥ 50 years, adults aged 19-49 years demonstrated significantly lower recombinant zoster vaccine uptake in both the short-term immunosuppression cohort (n = 1 128 matched pairs; HR 0.53, 95% CI 0.32-0.87) and long-term immunosuppression cohort (n = 785 matched pairs; HR 0.49, 95% CI 0.28-0.84). In contrast, influenza vaccine uptake was significantly higher among adults aged 19-49 years in both the short-term immunosuppression cohort (HR 1.80, 95% CI 1.20-2.70) and long-term immunosuppression cohort (HR 1.58, 95% CI 1.06-2.38).

Adults aged 19-49 years receiving immunosuppressive therapy for NOID demonstrated lower documented recombinant zoster vaccine uptake than older immunosuppressed adults despite current CDC recommendations supporting vaccination in both groups. These findings highlight a potential opportunity for improved vaccine counseling and implementation strategies among younger immunosuppressed adults.