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Improving rates of herpes zoster vaccination with a clinical decision support system in a primary care practice


  • Author contributions: All authors participated in the data analysis and helped draft the manuscript.

Dr Rajeev Chaudhry, Division of Primary Care Internal Medicine, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA, E-mail:


Rationale  Herpes zoster (shingles) is a localized neurocutaneous eruption of blisters caused by reactivation of the varicella zoster virus. The cost of care for herpes zoster and its complications is estimated at $1.1 billion. The Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices recommends a one-time dose of the vaccine for adults aged 60 years or older. Despite that recommendation, utilization of the vaccine is very low. One way to boost the delivery of preventive services such as vaccinations is with a computerized clinical decision support system. Our study found that the herpes zoster vaccination rate increased significantly after the implementation of such a system.

Aims  To study utilization of herpes zoster vaccine before and after the implementation of a web-based clinical decision support software solution in a primary care practice.

Methods  Billing data was utilized to determine number of herpes zoster vaccination administered to patients for a 12-month period during the implementation of the software solution.

Results  The utilization of vaccinations improved from 63 to 117 (53.8% increase) for one primary care practice and from 54 to 127 (42.5% increase) in the other primary care practice.

Conclusion  Herpes zoster vaccination rate significantly improved with implementation of a web-based clinical decision support system.