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

Abstract

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.

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

“…Even though this survey was conducted in countries with different vaccination policies for hepA and hepB in at-risk adults, the majority of HCPs considered all at-risk groups (defined as such in the national, WHO, and/or US CDC guidelines) as important to be vaccinated against hepA and hepB and would recommend both vaccines to most at-risk adults, in line with a recent report from a cross-sectional, web-based survey among HCPs in the US [36]. Most HCPs recommended hepA primarily to travellers to countries with intermediate/high endemic levels of hepA and to healthcare workers who might be in contact with hepA.…”

“…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.…”

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

“…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.…”

Pharmacovigilance in Vaccines: Importance, Main Aspects, Perspectives, and Challenges—A Narrative Review

“…Hepatitis B vaccination is a critical component of public health strategies aimed at preventing and controlling HBV infection. The Advisory Committee on Immunization Practices (ACIP) recommends the vaccination of specific populations to mitigate the risks associated with contracting or experiencing complications from hepatitis B [ 369 , 370 ].…”