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Optimizing Shingles Vaccine Uptake

CE / CME

Optimizing Shingles Vaccination: Current Trends and Expert Strategies for Improving Uptake and Series Completion

Pharmacists: 1.00 contact hour (0.1 CEUs)

Physicians: maximum of 1.00 AMA PRA Category 1 Credit™

Nurse Practitioners/Nurses: 1.00 Nursing contact hour

Released: January 30, 2026

Expiration: January 29, 2027

Jacinda (JAM) Abdul-Mutakabbir
Jacinda (JAM) Abdul-Mutakabbir, PharmD, MPH
Ruth Carrico
Ruth Carrico, PhD, DNP, FNP-C, FAAN
Dalilah Restrepo
Dalilah Restrepo, MD
CME/CE Information

Activity

Progress
1 2 3
Course Completed

Care Coordination Is a Foundation for RZV Uptake

Ruth Carrico, PhD, DNP, FNP-C, FAAN:
I think we tend to think about vaccination occurring in the primary care setting, but many patients receive care via a specialist or in an alternate healthcare setting, such as an urgent care or long-term care facility. Therefore, we need to think about what approaches we could use to best coordinate care.

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Strategies to Boost RZV Uptake

Ruth Carrico, PhD, DNP, FNP-C, FAAN:
Boosting RZV uptake starts with having vaccine-related discussions with patients. These discussions need to happen anywhere a patient is seen. Any time and any place we see a patient is an opportunity for vaccination.

How do we make sure that we are screening patients appropriately? We need to not only look at the age-based recommendation, but as Dr Restrepo said, we need to think about whether an individual has immunocompromise. There are many opportunities to think about when to have that conversation with patients.

Instead of having patients opt in to discussions about vaccination, we need to determine if there is a reason we should not be having that conversation. If your patients are like mine, very few of them would opt out.11,12

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Care Coordination Considerations to Support RZV Uptake

Ruth Carrico, PhD, DNP, FNP-C, FAAN:
I tend to think of having these conversations and making sure that the vaccine is provided in a step-wise process. If I you see a patient and do not have the shingles vaccine available, there should be a seamless referral process to a pharmacy or primary care HCP with documentation in the electronic health record so that it comes up at their next visit. Patients should also be engaged in the discussion so they are aware that the vaccination conversation may occur in other care settings. Coordination of care includes not only the settings in which patients may receive care, but patients themselves.

I also want to emphasize the decision support that may be available. Maybe it is through your electronic health record. There may be text messaging. Or maybe it is an individual at your institution, such as someone in the registration area, who tells patients that their HCPs are going to be discussing vaccination with them today. That may start the conversation with patients.

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NVAC Adult Vaccination Standards of Care for All HCPs

Ruth Carrico, PhD, DNP, FNP-C, FAAN:
How do we best prepare patients and the practice setting? HCPs must remember that patients hear our voices and they hear our silence just as loudly. If we do not bring up the vaccine recommendation, patients may incorrectly assume that it is not important for them. It is important for HCPs to provide strong recommendations as part of the care process.13

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How the Healthcare Team Can Support Vaccination

Ruth Carrico, PhD, DNP, FNP-C, FAAN:
It is equally important to remember that the entire healthcare team is involved. I mentioned the importance of starting the conversation at the time patients check in. You may find within your setting that it is helpful to have scripts for various members of the healthcare team so they know exactly how to broach the subject. If patients have questions, how are you best going to address them? It can help if you have some standard FAQs. You also need a way to pass off the information behind the scenes to other members of the healthcare team so they can continue the discussion.14

How do we make it easy for the right thing to happen and difficult for the wrong thing to happen? This is done best by engaging the entire healthcare team. We can do that.14

Dr JAM, what are your thoughts about the critical nature of the pharmacist's role in ensuring access to and administration of the shingles vaccine?

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Pharmacists' Role: Proactive Approaches to RZV Uptake

Jacinda (JAM) Abdul-Mutakabbir, PharmD, MPH:
In the pharmacy, first and foremost, we can identify ideal candidates for shingles vaccination. In a perfect world, we would have the beautiful care coordination between HCPs that Dr Carrico described, where a physician or nurse practitioner would call the pharmacy to let us know that they are referring someone and should have the vaccine ready for them.

Unfortunately, that oftentimes is not the case. What pharmacists can do instead is run reports on individuals presenting to their pharmacy who are immunocompromised or 50 years of age or older and encourage vaccination. Since we may not be able to quickly know that someone is immunocompromised from their patient profile history, we may be able to pull that information from their current medication list.

In the end, we must encourage and provide vaccination. As Dr Carrico said, we want to ensure that pharmacy staff provide a strong recommendation for the shingles vaccine. This is a vaccine that is available; it has been shown to be safe and effective; and it can prevent herpes zoster. That is the exact conversation we should have with patients.

We can also offer incentives, such as providing stickers as encouragement for receiving the vaccine.15,16

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Pharmacists' Role Across Care Settings

Jacinda (JAM) Abdul-Mutakabbir, PharmD, MPH:
Irrespective of the pharmacy setting, I believe that pharmacists have a unique opportunity to increase vaccine uptake. The roles of pharmacists are evolving, and ambulatory care pharmacists can provide this care, too. Therefore, pharmacists should provide vaccines right in their office or clinic in the outpatient setting, whether that be primary care, cardiology, pulmonology, or endocrinology.

The endocrinology clinics that I worked with would offer vaccines during patients’ visits because it was the perfect opportunity. This was a patient population—people with diabetes—that needed to be vaccinated.

Pharmacists also should indicate when vaccination is needed. For example, a patient is diagnosed with diabetes. During their visit you can tell them that diabetes is an immunocompromising disease state and that vaccines are important.

Next, pharmacists should partner with their community-based pharmacies. I work in a more ambulatory care setting, and I partner with my local pharmacies to provide vaccines. This way, we show that broad scope of what pharmacists can do in their different capacities.

Finally, pharmacists who work in transitions of care should assist with referrals for medication management that may be given to patients after discharge.

You can partner with your local health systems and health departments, too. Transitions of care pharmacists also can recommend vaccines to prevent rehospitalization due to subsequent illnesses. So there are many ways that pharmacists can step in and support vaccine uptake.17,18

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