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Hepatitis C performance measure on hepatitis A and B vaccination: missed opportunities?

Bridget Hernandez1, Noelle K Hasson, Ramsey Cheung

  • 1Pharmacy Service, VA Palo Alto Health Care System, Palo Alto, California 94304, USA.

The American Journal of Gastroenterology
|June 4, 2009
PubMed

Insights

This study found high adherence to hepatitis A and B vaccination guidelines in chronic hepatitis C patients. Missed opportunities remain the primary barrier to complete vaccination coverage.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Vaccinology

Background:

  • Vaccination against hepatitis A virus (HAV) and hepatitis B virus (HBV) is recommended for patients with chronic hepatitis C (CHC).
  • Physician performance measures have been adopted to track vaccination rates in CHC patients.
  • This study evaluated adherence to these new vaccination performance measures.

Purpose of the Study:

  • To determine adherence to physician performance measures for HAV and HBV vaccination in patients with chronic hepatitis C.
  • To identify reasons for non-adherence to vaccination recommendations in this patient population.

Main Methods:

  • Retrospective analysis of serology and immunization records from 2000 to 2007.
  • Inclusion of 2,968 patients with detectable hepatitis C virus (HCV) RNA.
  • Calculation of vaccination performance measure adherence rates for HAV and HBV.

Main Results:

  • Overall adherence rates were 71% for HAV, 70% for HBV, and 62% for both.
  • Among susceptible patients, 74% received HAV vaccination and 71% received HBV vaccination.
  • Major reasons for non-adherence included missed opportunities (41%) and vaccination outside the healthcare system (22%).

Conclusions:

  • Adherence to HAV and HBV vaccination recommendations in CHC patients is high and improving.
  • Missed opportunities represent the main barrier to achieving optimal vaccination rates.
  • Selective vaccination strategies may be effective in specific populations, such as veterans.
Abstract

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