Adherence with and completion of recommended hepatitis vaccination schedules among adults in the United States

Trantham, L; Kurosky, Samantha; Zhang, Dongmu; Johnson, Kelly

doi:10.1016/j.vaccine.2018.05.111

Cited by 35 publications

(31 citation statements)

References 13 publications

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“…In addition, similar to the present study, they found that older adults had better adherence rates. The earlier study of Nelson et al [20] in the US also found better adherence among older adult age groups and, for those adherent in all age groups, relatively long intervals between vaccine doses as in the present study and others [13].…”

Section: Discussionsupporting

confidence: 86%

“…Few studies have examined multi-dose vaccine series completion in general adult populations. The recent study of Trantham et al [13], designed similarly to the present study but using administrative claims data, reported somewhat higher, but still poor, rates of adherence in the US than in the UK, namely, rates of adherence to recommended schedules of 27, 30, and 18% for hepatitis A, hepatitis B, and hepatitis A/B, respectively. In addition, similar to the present study, they found that older adults had better adherence rates.…”

Section: Discussionsupporting

confidence: 59%

“…We studied almost half a million adults initiating hepatitis vaccination series, excluding patients receiving hepatitis B vaccination while on hemodialysis as they may not be representative of the general adult population. In addition, we used the KM method, used in few prior studies [13, 33, 34], to determine time to completion of second and third doses. The study design enabled us to identify the probable first vaccine dose by requiring baseline data periods of 6 to 12 months, extended to 18 to 24 months, depending on vaccine type, in sensitivity analyses.…”

Section: Discussionmentioning

confidence: 99%

“…There are few studies of series completion for multi-dose vaccinations in broad, general adult populations, and few studies have examined the rates of vaccine series completion within the recommended time frames [13], including none in the UK. We conducted a population-level analysis of vaccination completion rates using a large routinely collected dataset in the UK [17].…”

Section: Introductionmentioning

confidence: 99%

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Adherence to hepatitis A and hepatitis B multi-dose vaccination schedules among adults in the United Kingdom: a retrospective cohort study

Johnson

Lu²,

Zhang

2019

BMC Public Health

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Background Timely and complete vaccination with multi-dose schedules is of public health importance, because an incomplete vaccination series may yield suboptimal disease protection. However, data on adherence of adults to multi-dose vaccines are limited. We sought to estimate adherence to multi-dose hepatitis vaccination schedules among adults in the United Kingdom (UK). Methods This retrospective cohort study was conducted using anonymized electronic health record (EHR) data from the Clinical Practice Research Datalink (CPRD). Individuals aged 19 years and older at their first identified dose of hepatitis vaccine (2009–2016) were included if they had continuous EHR data for 12 months before the first identified hepatitis A dose or for 6 months before the first identified hepatitis B or combination hepatitis A/B dose. We estimated dose and series completion for each vaccine and adherence to recommended vaccination schedules, as well as adherence within additional prespecified time periods after the first vaccine dose, with sensitivity analyses restricted to adults who had available data for up to 24 months after the first dose. Median time to series completion was estimated using Kaplan-Meier methods. Results Mean (SD) age at initiation was 42 (16) years for hepatitis A ( n = 374,881), 40 (16) years for hepatitis B ( n = 71,634), and 38 (15) years for hepatitis A/B ( n = 10,335). Women comprised 52 to 55% of each vaccine cohort. Overall, 42,294 adults (11%) completed the two-dose hepatitis A vaccine series within the recommended 12 months; and 15,564 (22%) and 1076 (10%) completed the three-dose hepatitis B and hepatitis A/B series, respectively, within the recommended 6 months. These percentages rose to only 23, 35, and 33%, respectively, when the follow-up periods were extended to 36 months for hepatitis A and to 30 months for hepatitis B and A/B vaccines. Median times to series completion within recommended schedules were not reached in any cohort. Sensitivity analyses supported the primary findings for the full cohorts. Conclusions Adherence and series completion rates for hepatitis A and B vaccines in the UK are low. Identifying, understanding, and addressing barriers to series completion for multi-dose vaccines for adults in real-world settings are needed. Electronic supplementary material The online version of this article (10.1186/s12889-019-6693-5) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionsupporting

confidence: 59%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Adherence to hepatitis A and hepatitis B multi-dose vaccination schedules among adults in the United Kingdom: a retrospective cohort study

Johnson

Lu²,

Zhang

2019

BMC Public Health

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“…Although information regarding hepatitis A vaccination series completion rates is limited, low HAV vaccine series completion rates were observed among cohorts of commercial/Medicare (32%) and Medicaid (21%) enrollees in the United States (38). Additionally, adherence with and completion of recommended hepatitis vaccination schedules among adults in the United States have been described as suboptimal, leaving a substantial proportion of adults at risk (39). The same is true for adults in the United Kingdom, where adherence rates topped out at 23% (40).…”

Section: Discussionmentioning

confidence: 99%

Rapid Salivary IgG Antibody Screening for Hepatitis A

et al. 2020

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Hepatitis A virus (HAV) is a common infection that is transmitted through the fecal-oral route, shed in the stool of infected individuals and spread either by direct contact or by ingesting contaminated food or water. Each year, approximately 1.4 million acute cases are reported globally with a major risk factor for exposure being low household socioeconomic status. Recent trends show a decrease in anti-HAV antibodies in the general population, with concomitant increases in the numbers of HAV outbreaks. In line with a recreational water study, this effort aims to assess the prevalence of salivary IgG antibodies against HAV and subsequent incident infections (or immunoconversions) in visitors to a tropical beach impacted by a publicly owned treatment works (POTW). We applied a multiplex immunoassay to serially collected saliva samples gathered from study participants who recreated at Boquerón Beach, Puerto Rico. Analysis of assay results revealed an immunoprevalence rate of 16.17% for HAV with 1.43% of the cohort immunoconverting to HAV. Among those who immunoconverted, 10% reported chronic gastrointestinal symptoms and none experienced diarrhea. Tests on water samples indicated good water quality with low levels of fecal indicator bacteria, however, the collection and analysis of saliva samples afforded the ability to detect HAV infections in beachgoers. This rapid assay serves as a cost-effective tool for examining exposure to environmental pathogens and can provide critical information to policy makers, water quality experts and risk assessment professionals seeking to improve and protect recreational water and public health.

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Association Between 2-Dose vs 3-Dose Hepatitis B Vaccine and Acute Myocardial Infarction

Bruxvoort

Slezak

Qian

et al. 2022

JAMA

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IMPORTANCEThe 2-dose hepatitis B vaccine with a cytosine phosphoguanine adjuvant (HepB-CpG vaccine; Heplisav-B) generated higher seroprotection in prelicensure trials than did a 3-dose hepatitis B vaccine with an aluminum hydroxide adjuvant (HepB-alum vaccine; Engerix-B). However, in 1 trial, a higher number of acute myocardial infarction (MI) events were observed among those who received the HepB-CpG vaccine than among those who received the HepB-alum vaccine, an outcome requiring further study.OBJECTIVE To compare the rate of acute MI between recipients of HepB-CpG vaccine and HepB-alum vaccine. DESIGN, SETTING, AND PARTICIPANTSThis prospective cohort noninferiority study was conducted at Kaiser Permanente Southern California (KPSC), an integrated health care system with 15 medical centers and approximately 4.7 million members. The study included 69 625 adults not undergoing dialysis who received at least 1 dose of a hepatitis B vaccine in either family medicine or internal medicine departments at KPSC from August 7, 2018, to October 31, 2019 (November 30, 2020, final follow-up).EXPOSURES Receipt of HepB-CpG vaccine vs HepB-alum vaccine. The first dose during the study period was the index dose.MAIN OUTCOMES AND MEASURES Individuals were followed up for 13 months after the index dose for occurrence of type 1 acute MI. Potential events were identified using diagnosis codes and adjudicated by cardiologists. The adjusted hazard ratio (HR) of acute MI was estimated comparing recipients of HepB-CpG vaccine with recipients of HepB-alum vaccine, with inverse probability of treatment weighting (IPTW) to adjust for demographic and clinical characteristics. The upper limit of the 1-sided 97.5% CI was compared with a noninferiority margin of 2. RESULTSOf the 31 183 recipients of HepB-CpG vaccine (median age, 49 years; IQR, 38-56 years), 51.2% (n = 15 965) were men, and 52.7% (n = 16 423) were Hispanic. Of the 38 442 recipients of HepB-alum (median age, 49 years; IQR, 39-56 years), 50.8% (19 533) were men, and 47.1% (n = 18 125) were Hispanic. Characteristics were well-balanced between vaccine groups after IPTW. Fifty-two type 1 acute MI events were confirmed among recipients of HepB-CpG vaccine for a rate of 1.67 per 1000-person-years, and 71 type 1 acute MI events were confirmed among recipients of HepB-alum vaccine for a rate of 1.86 per 1000 person-years (absolute rate difference, −0.19 [95% CI, −0.82 to 0.44]; adjusted HR, 0.92 [1-sided 97.5% CI, −ϱ to 1.32], which was below the noninferiority margin; P < .001 for noninferiority). CONCLUSIONS AND RELEVANCEIn this cohort study, receipt of HepB-CpG vaccine compared with HepB-alum vaccine did not meet the statistical criterion for increased risk of acute myocardial infarction.

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Adherence with and completion of recommended hepatitis vaccination schedules among adults in the United States

Abstract: Hepatitis vaccine adherence and completion in adults is suboptimal. As a result, the majority of adults initiating each series may not be receiving the full protective benefit of these multidose vaccines.

Cited by 35 publications

References 13 publications

Adherence to hepatitis A and hepatitis B multi-dose vaccination schedules among adults in the United Kingdom: a retrospective cohort study

Adherence to hepatitis A and hepatitis B multi-dose vaccination schedules among adults in the United Kingdom: a retrospective cohort study

Rapid Salivary IgG Antibody Screening for Hepatitis A

Association Between 2-Dose vs 3-Dose Hepatitis B Vaccine and Acute Myocardial Infarction

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