OBJECTIVES : Herpes zoster (HZ) vaccination is recommended for all individuals 50+ years old, with few exceptions. Some studies have shown that chronic obstructive pulmonary disease (COPD) predisposes patients to HZ. However, little is known about the clinical profile of COPD patients at highest risk of HZ. The purpose of this analysis was to identify characteristics associated with HZ risk among COPD patients.

METHODS : Patients were selected from the IBM^® MarketScan^® Research Databases with 1+ inpatient or 2+ outpatient COPD diagnoses during 1/1/2012-9/30/2018, aged 40+ at first diagnosis during the study period (index date), continuously enrolled for 1+ year before and 2+ years after the index date, no prior evidence of HZ, and no evidence of HZ vaccination. Demographics were assessed on the index date, comorbidities and medication use were assessed over 12 months before index (baseline), and incidence of HZ was assessed over 2 years after index. Logistic regression estimated the odds of HZ associated with patient characteristics.

RESULTS : 232,478 COPD patients were identified, 6,117 (2.6%) of whom were diagnosed with HZ during the 2-year follow-up period. Females were 27% more likely than males to develop HZ (p<0.001). Baseline clinical characteristics associated with a significant (all p<0.02) increase in risk of HZ included evidence of being immune compromised (autoimmune disease diagnoses including lupus, RA, Sjogren’s, scleroderma, dermatomyositis/polymyositis: OR=1.4; malignancy: OR=1.3; systemic corticosteroid use: OR=1.2; immunosuppressant medication use: OR=1.2), history of other respiratory illnesses (respiratory infections: OR=1.2; sinusitis: OR=1.1: allergic rhinitis: OR=1.1), and other serious chronic health conditions (hemiplegia/paraplegia: OR=1.5; myocardial infarction: OR=1.2; renal disease: OR 1.1).

CONCLUSIONS : COPD patients with comorbidities and medications associated with immunosuppression, other respiratory illnesses, and serious chronic conditions are at greater risk of developing HZ. Provider awareness of these risk factors could improve HZ vaccination coverage among COPD patients.