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Education, herpes zoster, immunization, vaccination



  1. O'Donnell, Margaret DNP, FNP, ANP-BC, FAANP
  2. Shurpin, Kathleen PhD
  3. Janotha, Brenda EdD, DNP-DCC, ANP-BC


Background and purpose: Despite demonstrated efficacy, the utilization of herpes zoster vaccine (HZV), recommended by the Centers for Disease Control (CDC) for all immunocompetent adults aged above 60 years, is low (31%). The aim of this study was to identify nurse practitioner (NP) barriers to HZV administration and then to use these results to develop and evaluate the outcomes of an educational program.


Methods: This study used a two-phase design. In Phase I, barriers that obstruct the provision of HZV were identified and NPs were surveyed to determine current HZV practice. The second phase used a quasiexperimental pretest-posttest design to evaluate the impact of the constructed program.


Conclusions: In Phase I, NYS Primary Care NPs with practice years ranging from 1 to 24, who reported working in practice sites that ranged from 1 to 20 providers, possessed limited knowledge of the vaccine, especially, the financial aspects of the vaccination such as up-front cost (46%), cost to patients (39%), and reimbursement (29%), resulting in fewer provider recommendations. In Phase II, a paired-samples t test revealed a statistically significant difference between pretest scores (mean = 3.4, SD = 1.2) and posttest scores (mean = 4.7, SD = 1.3) on the knowledge survey, t (37) = -7.1, p < .0, demonstrating NPs' improved understanding of HZV.


Implications for practice: Nurse practitioners will increase compliance with the CDC recommendations for HZV administration.