Perception et attitude des médecins généralistes en Isère concernant la vaccination contre le zona depuis les nouvelles recommandations 2024 : étude qualitative

Introduction: Herpes zoster is a reactivation of the VZV virus, affecting 20 to 25% of the population. It can cause numerous serious complications with a potential impact on the quality of life of those affected. Zostavax® was underprescribed with insufficient vaccination coverage between 2013 and 2024. Following the new 2024 recommendations concerning the Shingrix® vaccine, we’ve investigated the perceptions and current stances of general practitioners in Isère regarding herpes zoster vaccination. Method: We’ve conducted a qualitative study to gather the experiences and opinions of substitute or practicing general practitioners in Isère. Fourteen semi-structured interviews were carried out. Results: Physicians consider themselves proactive regarding vaccination in general and trust scientific data: they are the main actors in vaccine prevention. They have knowledge about herpes zoster and as well as the impact of postherpetic neuralgia on patients' quality of life, yet some serious complications remain unknown. Most reported cases of severe herpes zoster in their past experiences were associated with difficulties to manage their care. While most are familiar with herpes zoster vaccination, Zostavax® was still rarely prescribed or not prescribed at all due to its low efficacy and high cost. The majority of physicians are up-to-date with the new recommendation, Shingrix® appears to be prescribed more frequently, but its use on immunocompromised patients is underutilized. Obstacles to its prescription remain : its recentness, the two-dose regimen, the sheer number of vaccines and mistrust surrounding them, a lack of awareness, and the trivialization of herpes zoster. They also find it difficult to offer the vaccine due to the time-consuming nature of prevention and the concurrent changes in recommendations. The promotion of this vaccine is unique as it involves public information campaigns that have had a positive impact, thus encouraging patient adherence to vaccination. Several avenues for improvement are still being explored: vaccination campaigns in nursing homes, a government vaccination campaign, an invitation letter for vaccination at the age of 65, a dedicated preventive consultation, printed informational materials, and regular training for doctors. Most practitioners are aware of the impact of herpes zoster and therefore the benefits that vaccination can bring. Conclusion: This study is one of the first to focus on the practices of general practitioners since the change in recommendations with the arrival of Shingrix®. It appears to be prescribed more than its predecessor despite a lack of long-term data. A follow-up study could help verify whether this trend will sustain. A similar study conducted with patients would allow exploration of their knowledge about herpes zoster and their views on vaccination.