Increasing Use of the Vaccine Against Herpes Zoster/Shingles at NYULMC and Bellevue Hospital

• Change in proportion of eligible patients who are vaccinated after 1 year [ Time Frame: 1 year ] [ Designated as safety issue: No ]
  Assessed by physician survey. The primary comparison will focus on the differences in the changes from baseline in the mean proportions of patients vaccinated in the intervention groups compared to the no intervention groups. Results will be presented as self-reported vaccination rates obtained from baseline and 1 year follow up surveys.
  
  

• Correlation between physician characteristics, provider setting, and perceived barriers to vaccination and implemented interventions [ Time Frame: 1 year ] [ Designated as safety issue: No ]
  Assessed by physician survey. Statistical analysis of baseline and 1 year follow-up survey results regarding differences in physician characteristics, provider setting, and perceived barriers to vaccination between sites that received interventions and sites that did not receive interventions. Results will be presented as differences in survey answers.
  
  
• Patient characteristics associated with vaccination success [ Time Frame: From date of recruitment until the date of first 100 patients are enrolled in Part 2, an expected period of 2 months ] [ Designated as safety issue: No ]
  Assessed by patient survey. Survey of patient characteristics among patients who agreed to vaccination following screening by ophthalmologists compared with patients who decline vaccination. Results will be presented as differences in survey answers.
  
  

Behavioral: Education
Electronic medical record reminders, baseline survey answers, Medical Grand Rounds presentation, internal communications from Pharmacy, Nursing and the Chief Medical Officer, and availability of the vaccine at the NYU outpatient pharmacy and Bellevue Eye Clinic.

This study will have 2 parts. In Part 1 of this study, a confidential survey of general internal medicine physicians (n=330) in various practice settings in an academic medical center will be administered to determine baseline knowledge, attitudes, and practices regarding herpes zoster and the Zostavax vaccine. A 1 year follow up survey will be administered after educational interventions and a change in delivery of the vaccine by providing dedicated hours at the main out-patient pharmacy for a nurse to be available to administer the vaccine.

In part 2 of the study, patient vaccination behaviors will be assessed after 100 doses of the Zostavax vaccine are provided to underserved patients screened by ophthalmologists at the General Eye Clinic at a public hospital that does not normally provide the vaccine. A nurse will be at the clinic to administer the vaccine. Patients will be contacted by phone 1 month later and seen within 3 months in the Eye Clinic to determine whether there were any side effects.