Screening and Vaccination Rates for Tetanus, Hepatitis A, and Hepatitis B Among Individuals With Substance Use...

Hepatitis A virus (HAV) infection, hepatitis B virus (HBV) infection, and tetanus are important vaccine-preventable infections among individuals with substance use disorder. Hospitalizations may represent opportunities for preventive care. Up-to-date data on screening and vaccination practices for this high-risk population are needed in these settings.

In a retrospective cohort study, we included adults hospitalized at Kaiser Permanente Southern California between 2010 and 2023, with a substance use disorder diagnosis within 2 years prior. We described (1) HAV and HBV screening at any hospitalization and (2) vaccine uptake during hospitalization and within 90 days after discharge (surveillance period) for tetanus, HAV, and HBV.

Among 465 282 eligible individuals, 41.8% were female, 45.0% were non-Hispanic white, and 33.9% were Hispanic; their mean age (SD) was 48.0 (19.0) years. For tetanus, 329 384 (70.8%) received a booster within 10 years before the first hospitalization. Among 21 115 at risk for tetanus, 22% were vaccinated during a surveillance period. For HAV, 87 498 (18.8%) completed vaccinations/had immunity before the first hospitalization. Among 377 774 at risk for HAV, 1.3% were screened for immunity at any hospitalization, and 0.8% initiated HAV vaccinations during a surveillance period. For HBV, 96 884 (20.8%) completed HBV vaccinations before the first hospitalization. Among 354 073 at risk for HBV, 1.7%, 5.3%, and 3.6% were screened for immunity, active infection, and previous HBV exposure, respectively, at any hospitalization; 3.2% initiated vaccinations during a surveillance period.

Hospitalization encounters may present an opportunity to improve infection screening and vaccination in this high-risk population to prevent vaccine-preventable infectious diseases with serious complications.