Hepatitis vaccination adherence and completion rates and factors associated with low compliance: A claims-based analysis of U.S. adults

Abstract

Poor compliance with multi-dose vaccine schedules by adults for whom hepatitis (Hep) A and B vaccines are recommended contributes to major Hep A and B disease burdens among high-risk U.S. adults. Evidence on hepatitis vaccine series adherence, completion, timeliness of completion, and factors associated with these outcomes, is limited and not readily generalizable for U.S. adults. This retrospective, observational study examined adherence, completion, its timeliness, and the impact of sociodemographic and clinical factors on these outcomes among a large, geographically representative sample of U.S. adults. We analyzed the Optum Clinformatics SES administrative claims database (1/1/2010-6/30/2020) for recipients of 2-dose (HepA, HepB2) or 3-dose (HepB3, HepAB) hepatitis vaccines. Adherence was defined as receipt of booster doses within specified assessment periods, per label-recommended schedules. Completion (receipt of all doses) was assessed at 6, 12, 18, and 24 months.The study included 356,828 adults ≥19 years old who were continuously enrolled in a medical benefit plan for one (HepB2), six (HepB3; HepAB), or 18 months (HepA) prior to and following the index date (first observed vaccine dose). Adherence and 24-month completion rates were: HepA (27.0%, 28.4%), HepB2 (32.2%, 44.8%), HepB3 (14.3%, 37.3%), HepAB, (15.3%, 33.8%). Kaplan-Meier completion curves plateaued after about 6 months for HepB2 and about 12 months for HepA, HepB3, and HepAB vaccines. Logistic regression analyses showed risk for low adherence/completion was generally associated with male gender, younger age, Black or Hispanic race/ethnicity, lower educational or household income attainment, and more comorbidities. Adherence and completion rates for all hepatitis vaccine series are low, especially for males, younger adults, those with lower socio-economic status and more comorbidities. To our knowledge, this is the largest claims-based analysis of adherence and completion rates for U.S. adults initiating all currently available HepA and HepB vaccines. Findings may inform hepatitis vaccination programming.

The association between internet use to obtain health information and receiving three doses of the Hepatitis B vaccine in a multi-ethnic population in Ohio

“…These findings support a recent study that found lower rates of HBV vaccination adherence to be associated with lower educational attainment ( LaMori et al, 2022 ). Our results also support previous research conducted in different locations and with different populations that highlights the lower HBV vaccination coverage among Hispanics and African Americans when compared to whites ( Bhuiyan et al, 2020 ).…”

Evolving considerations for choice of hepatitis B vaccine

“…Among individuals who received the 2-dose vaccine series, Heplisav-B, adherence rates were more than 2-fold higher (32.2%) than in individuals who received traditional 3-dose (Engerix-B and Recombivax-HB) HBV vaccines (14.3%). This difference in adherence rates was consistent across all age groups 27. Supplemental data further highlighted vaccination adherence and completion (24 months) rates for hepatitis A, hepatitis B (3-dose series), and combination hepatitis A and B vaccines (3-dose series) among special at-risk or high-risk populations with chronic comorbidities (diabetes with and without chronic complications, mild to severe liver disease, and renal disease).…”

SFTSV Gn‐Head mRNA vaccine confers efficient protection against lethal viral challenge

“…While protein subunit vaccines have been successfully applied against a limited number of pathogens, logistical challenges, including high production costs and the need for three or more immunizations, have hindered their broader application. [45][46][47] The advent of mRNA LNP vaccines, exemplified by the rapid development and distribution to combat the COVID-19 pandemic, offers a promising solution to address these challenges. 36,37 mRNA-1273 and BNT162b2, developed under "Project Lightspeed," were swiftly distributed, significantly reducing hospitalizations and fatalities caused by SARS-CoV-2.…”