Carolyn B Bridges1, Tureka L Watson2, Noele P Nelson3, Maribel Chavez-Torres4, Patrick Fineis5, Boatemaa Ntiri-Reid6, Edward Wake7, Judith M Leahy8, Anita K Kurian9, Mary Ann K Hall10, Erin D Kennedy11. 1. Berry Technology Solutions, Inc., Peachtree City, GA, United States. Electronic address: carolyn.bridges@immunize.org. 2. IHRC, Inc., Atlanta, GA, United States. Electronic address: twatson@cdc.gov. 3. Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC, Atlanta, GA, United States. Electronic address: nnelson@cdc.gov. 4. Communicable Disease Program, Chicago Department of Public Health, Chicago, IL, United States. Electronic address: maribel.chavez-torres@cityofchicago.org. 5. Division of Immunization, Michigan Department of Health & Human Services, Lansing, MI, United States. Electronic address: fineisp@michigan.gov. 6. Infectious Disease Prevention and Health Services Bureau, Prevention and Health Promotion Administration, Maryland Department of Health, Baltimore, MD, United States. Electronic address: boatemaa.ntiri-reid@maryland.gov. 7. Immunization Services Division, NCIRD, CDC and Adult Immunization Unit, New York City Department of Health and Mental Hygiene, New York, NY, United States. Electronic address: ewake@health.nyc.gov. 8. Public Health Division, Oregon Health Authority, Portland, OR, United States. Electronic address: Judith.m.leahy@state.or.us. 9. San Antonio Metropolitan Health District, San Antonio, TX, United States. Electronic address: anita.kurian@sanantonio.gov. 10. Cherokee Nation Assurance, Atlanta, GA, United States. Electronic address: nmp8@cdc.gov. 11. Immunization Services Division, NCIRD, CDC, Atlanta, GA, United States. Electronic address: edkennedy@cdc.gov.
Abstract
BACKGROUND: Acute hepatitis B virus (HBV) infections in the United States occur predominantly among persons aged 30-59 years. The Centers for Disease Control and Prevention (CDC) recommends vaccination of adults at increased risk for HBV infection. Completing the hepatitis B (HepB) vaccine dose-series is critical for optimal immune response. OBJECTIVES: CDC funded 14 health departments (awardees) from 2012 to 2015 to implement a pilot HepB vaccination program for high-risk adults. We evaluated the pilot program to assess vaccine utilization; vaccine dose-series completion, including by vaccination location type; and implementation challenges. METHODS: Awardees collaborated with sites providing health care to persons at increased risk for HBV infection. Awardees collected information on doses administered, vaccine dose-series completion, and challenges completing and tracking vaccinations, including use of immunization information systems (IIS). Data were reported by each awardee in aggregate to CDC. RESULTS: Six of 14 awardees administered 47,911 doses and were able to report patient-level dose-series completion. Among persons who received dose 1, 40.4% received dose 2, and 22.3% received dose 3. Local health department clinics had the highest 3-dose-series completion, 60.6% (531/876), followed by federally qualified health centers at 38.0% (923/2432). While sexually transmitted diseases (STD) clinics administered the most doses in total (17,173 [35.8% of 47,911 doses]), 3-dose-series completion was low (17.1%). The 14 awardees reported challenges regarding completing and tracking dose-series, including reaching high-risk adults for follow-up and inconsistencies in use of IIS or other tracking systems across sites. CONCLUSIONS: Dose-series completion was low in all settings, but lowest where patients may be less likely to return for follow-up (e.g., STD clinics). Routinely assessing HepB vaccination needs of high-risk adults, including through use of IIS where available, may facilitate HepB vaccine dose-series completion.
BACKGROUND: Acute hepatitis B virus (HBV) infections in the United States occur predominantly among persons aged 30-59 years. The Centers for Disease Control and Prevention (CDC) recommends vaccination of adults at increased risk for HBV infection. Completing the hepatitis B (HepB) vaccine dose-series is critical for optimal immune response. OBJECTIVES: CDC funded 14 health departments (awardees) from 2012 to 2015 to implement a pilot HepB vaccination program for high-risk adults. We evaluated the pilot program to assess vaccine utilization; vaccine dose-series completion, including by vaccination location type; and implementation challenges. METHODS: Awardees collaborated with sites providing health care to persons at increased risk for HBV infection. Awardees collected information on doses administered, vaccine dose-series completion, and challenges completing and tracking vaccinations, including use of immunization information systems (IIS). Data were reported by each awardee in aggregate to CDC. RESULTS: Six of 14 awardees administered 47,911 doses and were able to report patient-level dose-series completion. Among persons who received dose 1, 40.4% received dose 2, and 22.3% received dose 3. Local health department clinics had the highest 3-dose-series completion, 60.6% (531/876), followed by federally qualified health centers at 38.0% (923/2432). While sexually transmitted diseases (STD) clinics administered the most doses in total (17,173 [35.8% of 47,911 doses]), 3-dose-series completion was low (17.1%). The 14 awardees reported challenges regarding completing and tracking dose-series, including reaching high-risk adults for follow-up and inconsistencies in use of IIS or other tracking systems across sites. CONCLUSIONS: Dose-series completion was low in all settings, but lowest where patients may be less likely to return for follow-up (e.g., STD clinics). Routinely assessing HepB vaccination needs of high-risk adults, including through use of IIS where available, may facilitate HepB vaccine dose-series completion.
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