Transcript Presentation - Canadian Public Health Association

Knowledge, Attitudes and Beliefs of
Older Canadians and Their Healthcare
Providers Regarding Shingles Vaccine
D Shaw, D Cravit & S McNeil
June 2, 2008
Background

Shingles (herpes zoster) carries a significant
burden of disease – particularly in those over
60y
 130,000 cases of shingles
 360,000 health care visits
 17,000 cases of post-herpetic neuralgia (PHN)
 2,000 hospitalizations
 Contributes to 20 deaths
 Annual healthcare cost est $69 million
Brisson M. J Infect. 2002
Shingles Vaccine

New live-attenuated vaccine against shingles
(Zostavax, Merck) to be approved in Canada in
near future
95% CI
Zoster
PHN
BOI
0
25
50
Vaccine Efficacy (%)
75
100
Objectives
1.
2.
3.
4.
What is the perceived burden of illness of shingles
among Canadians over 60y?
Are older Canadians willing to receive the shingles
vaccine?
Are healthcare providers for older Canadians
(family, internal, geriatrics, infectious diseases,
dermatology) willing to recommend the shingles
vaccine?
Who do these groups think should pay for the
shingles vaccine?
Methods



Surveys designed, tested for content validity
and test-retest reliability and piloted
Web-based survey emailed to members of the
Canadian Association of Retired Persons aged
 60y
Web-based and paper-based survey
distributed to NS physicians- Family Medicine,
Internal Medicine, Geriatrics, Dermatology,
Infectious Diseases
Results



603 older Canadian responses; all Provinces
and Territories represented
161 NS physician responses (25% response
rate)
No differences in main outcomes by age,
gender, province/territory of residence
(older), education (older), income (older),
specialty of medicine (physician), years spent
in practice (physician)
Results – Burden of Shingles


48% of older Canadians reported at least one
episode of shingles
 40% experienced PHN
82% older Canadians had friend/family
member with shingles
Results- Vaccine Acceptability


87% of older Canadians willing to receive the vaccine
if safe and recommended by physician
 87% think vaccine should be publicly funded for
those over 60y
 67% willing to pay out-of-pocket
93% of NS physicians indicated willing to recommend
vaccine if it prevents shingles
 94% of NS physicians think vaccine should be
publicly funded for those over 60y
Results- Factors associated with older
Canadian willingness to receive shingles
vaccine (regression)
Results: Variables associated with
Physician willingness to recommend
shingles vaccine
Summary




Shingles associated with significant burden of illness
Majority of older adults would accept vaccine if
recommended by their physician (87%)
93% of NS physicians responsible for healthcare of
elderly intend to recommend shingles vaccine
Majority of older adults (87%) and physicians (94%)
believe that shingles vaccine should be publicly
funded for older Canadians; smaller majority of older
Canadians willing to pay for shingles vaccine out-ofpocket
Conclusion


Demand for the shingles vaccine is likely to
be high among older Canadians and their
healthcare providers
Careful consideration of program feasibility
and cost effectiveness of publicly-funded
shingles vaccine is warranted
Acknowledgements





Dalhousie Music-in-Medicine Program
Capital Health Research Fund
Brian Hoyt
Petra Rykers
Kimberly Brooks
Questions