Improving hepatitis A vaccination rates in hospitalised patients with cirrhosis: insights and lessons learnt

Kronen, Ryan; Haff, Madeleine G.; Patwardhan, Vilas; LaSalvia, Mary T.

doi:10.1136/bmjoq-2021-001723

Cited by 2 publications

(1 citation statement)

References 9 publications

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“…Incomplete data on HepA vaccination rates was described as a challenge, as reporting HepA vaccination in immunization information systems is not required in some states [ 72 ]. Limited funding was also commonly reported, with supplies, vaccines, and storage equipment further constrained during the coronavirus disease 2019 (COVID-19) pandemic [ 26 , 56 , 57 , 66 , 73 , 74 ]. Additional challenges in outbreak management among at-risk populations were observed at a more systemic level.…”

Section: Resultsmentioning

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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Section: Resultsmentioning

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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Fixing a Hole: a retrospective cohort study evaluating HAV, HBV, tetanus screening, and vaccination during hospitalization in persons who use substances

Streifel,

Rivera Sarti,

Sikka

et al. 2024

Therapeutic Advances in Infection

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Background: Rates of serious injection-related infections in persons who use drugs have increased. Resulting admissions are an opportunity for screening and vaccination of preventable infections such as hepatitis A virus (HAV), hepatitis B virus (HBV), and tetanus. Design and methods: We conducted a retrospective review of adults with documented substance use admitted for bacterial infection between July 2015 and March 2020. We evaluated HAV, HBV, and tetanus vaccination status at admission, along with screening for HAV and HBV infection and immunity. We identified the proportion of patients at risk for infection who received HAV, HBV, and tetanus vaccines during admission and patient-level factors associated with vaccination. Results: We identified 280 patients who met our inclusion criteria. Of the 198 (70.7%) patients at risk for HAV, infectious disease providers recommended vaccination for 21 (10.6%) and 15 (7.6%) received HAV vaccine. Of the 174 (62.1%) patients at risk for HBV, infectious disease providers recommended vaccination for 32 (18.3%) and 25 (14.4%) received HBV vaccine. A large proportion of patients (31.4%, 88) had no documentation of prior tetanus vaccination, and infectious disease providers recommended tetanus vaccination for three (1.1%) and five patients (1.8%) received a tetanus booster. Infectious disease consult vaccine recommendations were statistically significantly associated with HAV or HBV vaccination prior to discharge. Conclusion: Over 70% of our population is at risk for one or more of these preventable infections. Efforts are needed to maximize inpatient screening and vaccination for HAV, HBV, and tetanus in patients with barriers to care.

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Improving hepatitis A vaccination rates in hospitalised patients with cirrhosis: insights and lessons learnt

Cited by 2 publications

References 9 publications

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

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

Fixing a Hole: a retrospective cohort study evaluating HAV, HBV, tetanus screening, and vaccination during hospitalization in persons who use substances

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