Health Care Providers’ Knowledge, Practices, and Barriers to Hepatitis Vaccination Guidelines

Ghaswalla, Parinaz; Davis, Kimberly; Sweeney, Carolyn; Davenport, Eric; Trofa, Andrew F.; Herrera-Restrepo, Oscar; Buck, Philip O.

doi:10.1016/j.nurpra.2021.12.028

Cited by 3 publications

(5 citation statements)

References 15 publications

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“…Consistent with previous surveys, more than half of HCPs considered the nondisclosure of risk factors by the patient as the main reason for not recommending hepA and hepB vaccines [37,39]. However, since HCPs may not necessarily be aware that their patients might be at risk for hepA and/or hepB (e.g., people travelling to countries with intermediate/high endemicity for hepA and/or hepB), they could proactively inform them on the possibility of hepA and/or hepB vaccination by using, for example, information leaflets displayed in their waiting rooms.…”

Section: Discussionsupporting

confidence: 74%

“…Most participants were familiar with their national vaccination guidelines and always followed them or followed them most of the time when recommending or prescribing hepA, hepB, or combined hepA/hepB vaccines in at-risk adults. In a similar survey conducted in the US, comparable percentages of HCPs recommending and/or prescribing hepA and hepB vaccines were reported [37]. In our survey, most UK HCPs working in sexual health clinics were familiar with their national vaccination recommendations; however, a lower proportion of them declared that they never follow these guidelines or only follow them sometimes when recommending or prescribing a hepA, hepB, and/or combined hepA/hepB vaccine compared to HCPs in Germany, Spain, and UK GPs/FPs.…”

Section: Discussionmentioning

confidence: 78%

“…No formal hypothesis testing was conducted for this study; therefore, sample size calculations based on a powered hypothesis test were not formally performed to derive the most appropriate sample size. Rather, appropriate sample sizes were determined based on considerations of the sample from the U.S.-based study [36,37], the number of HCPs available within country-specific panels, and the resulting general exact 95% confidence interval (CI) widths for the proposed samples. Although a simple random sample strategy component was present, this sample was one of convenience.…”

Section: Discussionmentioning

confidence: 99%

“…However, different policies are applied by the NHS when reimbursing the costs of hepA, hepB, and combined hepA/hepB vaccines [40,41], and this may be the reason why a lower proportion of HCPs in the UK declared that they recommend, prescribe, and/or administer the combined hepA/hepB vaccines than in Germany and Spain. In the US, where hepA/hepB vaccination is generally not reimbursed, out-of-pocket cost was also identified as an important barrier for vaccination [37]. Reducing financial barriers to the administration of such vaccines in at-risk groups should therefore be among the strategies adopted by each country to increase hepA and hepB vaccination coverage and prevent new infections, especially in view of the goal set by the WHO for reducing viral hepatitis by 2030.…”

Section: Discussionmentioning

confidence: 99%

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Knowledge, Attitudes, and Practices of European Healthcare Professionals towards Hepatitis A and Hepatitis B Vaccination in at-Risk Adults

Shamarina,

Sluga-O’Callaghan,

Kassianos

et al. 2023

Vaccines

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Despite the occurrence of several hepatitis A (hepA) and hepatitis B (hepB) outbreaks in Europe in the last few decades, not all European countries have implemented hepA and hepB vaccinations in their national immunization programs, especially for adults at risk for hepA and/or hepB infection, such as men who have sex with men or patients with chronic liver disease. Currently, little is known on the attitudes of European healthcare professionals (HCPs) towards hepA and hepB vaccinations for at-risk adults. We conducted an online survey among HCPs in Germany, Spain, and the United Kingdom to assess their awareness of and adherence to their national hepA and hepB vaccination guidelines for at-risk adults. Among the 698 HCPs who took the survey, most (91.1%) were familiar with their national vaccination recommendations and always followed them or followed them most of the time when advising or prescribing hepA or hepB vaccines. Major and moderate barriers for recommending or administering such vaccines were the non-disclosure of risk factors by the patient (53.0–57.6%) and the patient’s lack of motivation or knowledge about the risk of the disease (50.3–52.9%). These results may help inform strategies to improve and accelerate hepA and hepB vaccination in European at-risk adults.

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Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Knowledge, Attitudes, and Practices of European Healthcare Professionals towards Hepatitis A and Hepatitis B Vaccination in at-Risk Adults

Shamarina,

Sluga-O’Callaghan,

Kassianos

et al. 2023

Vaccines

Self Cite

View full text Add to dashboard Cite

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“…In addition, although HepA and HepA & HepB combination vaccines are available and recommended for adults by the ACIP, adherence to and knowledge of ACIP guidelines vary, and some HCPs still report not recommending vaccination against HepA for reasons including low perceived risk of certain patient populations and uncertainty of guidelines [ 82 , 83 ]. Focusing on prevention, including targeted efforts in HCP education, could be beneficial in increasing vaccine uptake and reducing HepA disease burden.…”

Section: Discussionmentioning

confidence: 99%

The Burden of Hepatitis A Outbreaks in the United States: Health Outcomes, Economic Costs, and Management Strategies

Horn,

Herrera-Restrepo,

Acosta

et al. 2024

The Journal of Infectious Diseases

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Background Hepatitis A (HepA) vaccines are recommended for United States (US) adults at risk of HepA. Ongoing US HepA outbreaks since 2016 have primarily spread person-to-person, especially among at-risk groups. We investigated the health outcomes, economic burden, and outbreak management considerations associated with HepA outbreaks from 2016 onwards. Methods A systematic literature review was conducted to assess HepA outbreak-associated health outcomes, healthcare resource utilization (HCRU), and economic burden. A targeted literature review evaluated HepA outbreak management considerations. Results Across 33 studies reporting on HepA outbreak-associated health outcomes/HCRU, frequently reported HepA-related morbidities included acute liver failure/injury (n=6 studies/33 studies) and liver transplantation (n=5/33); reported case fatality rates ranged from 0–10.8%. Hospitalization rates reported in studies investigating person-to-person outbreaks ranged from 41.6–84.8%. Ten studies reported on outbreak-associated economic burden, with a national study reporting an average cost of over $16,000 per hospitalization. Thirty-four studies reported on outbreak management; challenges included difficulty reaching at-risk groups and vaccination distrust. Successes included targeted interventions and increasing public awareness. Conclusions This review indicates a considerable clinical and economic burden of ongoing US HepA outbreaks. Targeted prevention strategies and increased public awareness and vaccination coverage are needed to reduce HepA burden and prevent future outbreaks.

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Hepatitis A and B vaccination in adults at risk: A survey of US healthcare providers’ attitudes and practices

Herrera-Restrepo

Davis

Sweeney

et al. 2022

Human Vaccines & Immunotherapeutics

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This study aimed to evaluate the attitudes and practices of US healthcare professionals (HCPs) regarding the Advisory Committee on Immunization Practices (ACIP) vaccination recommendations on HepA and HepB for adult patients at risk of contracting these infections or experiencing complications of hepatitis disease. This cross-sectional, web-based survey of 400 US HCPs, which included nurse practitioners and family medicine, internal medicine, infectious disease, emergency department, and gastroenterology physicians, assessed HCPs’ attitudes and practices regarding the ACIP recommendations for adult patients at risk for hepatitis disease. HCP participants were identified via a survey research panel. A recruitment quota of 400 HCPs was set, including 50 NPs, 100 FMs, 100 IMs, 50 GIs, 50 EDs, and 50 IDs. The most frequently reported reasons for not recommending either HepA or HepB vaccines were “I think the risk of HepA infection is low in this patient population” and “I am uncertain about what the guidelines say about vaccinating this population.” The most reported factors considered when determining eligibility for either vaccine were medical history and the patient’s willingness/motivation to be vaccinated. Most reported it was extremely or moderately important to prevent hepatitis disease by vaccinating adult patients at risk, and most also reported recommending a HepA vaccine or HepB vaccine to patients at risk. Although most HCPs reported recommending HepA and HepB vaccines to patients at risk, these findings contrast with the low reported vaccination rates among these populations, and improved awareness of the ACIP recommendations among HCPs is needed.

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Health Care Providers’ Knowledge, Practices, and Barriers to Hepatitis Vaccination Guidelines

Cited by 3 publications

References 15 publications

Knowledge, Attitudes, and Practices of European Healthcare Professionals towards Hepatitis A and Hepatitis B Vaccination in at-Risk Adults

Knowledge, Attitudes, and Practices of European Healthcare Professionals towards Hepatitis A and Hepatitis B Vaccination in at-Risk Adults

The Burden of Hepatitis A Outbreaks in the United States: Health Outcomes, Economic Costs, and Management Strategies

Hepatitis A and B vaccination in adults at risk: A survey of US healthcare providers’ attitudes and practices

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