Janssen Scientific Affairs, Titusville, New Jersey, United States of America.
Janssen Medical Affairs, Titusville, New Jersey, United States of America.
PLoS One. 2022 Feb 17;17(2):e0264062. doi: 10.1371/journal.pone.0264062. eCollection 2022.
Poor compliance with multi-dose vaccine schedules by adults for whom hepatitis (Hep) A and B vaccines are recommended contributes to major Hep A and B disease burdens among high-risk U.S. adults. Evidence on hepatitis vaccine series adherence, completion, timeliness of completion, and factors associated with these outcomes, is limited and not readily generalizable for U.S. adults. This retrospective, observational study examined adherence, completion, its timeliness, and the impact of sociodemographic and clinical factors on these outcomes among a large, geographically representative sample of U.S. adults. We analyzed the Optum Clinformatics SES administrative claims database (1/1/2010-6/30/2020) for recipients of 2-dose (HepA, HepB2) or 3-dose (HepB3, HepAB) hepatitis vaccines. Adherence was defined as receipt of booster doses within specified assessment periods, per label-recommended schedules. Completion (receipt of all doses) was assessed at 6, 12, 18, and 24 months.The study included 356,828 adults ≥19 years old who were continuously enrolled in a medical benefit plan for one (HepB2), six (HepB3; HepAB), or 18 months (HepA) prior to and following the index date (first observed vaccine dose). Adherence and 24-month completion rates were: HepA (27.0%, 28.4%), HepB2 (32.2%, 44.8%), HepB3 (14.3%, 37.3%), HepAB, (15.3%, 33.8%). Kaplan-Meier completion curves plateaued after about 6 months for HepB2 and about 12 months for HepA, HepB3, and HepAB vaccines. Logistic regression analyses showed risk for low adherence/completion was generally associated with male gender, younger age, Black or Hispanic race/ethnicity, lower educational or household income attainment, and more comorbidities. Adherence and completion rates for all hepatitis vaccine series are low, especially for males, younger adults, those with lower socio-economic status and more comorbidities. To our knowledge, this is the largest claims-based analysis of adherence and completion rates for U.S. adults initiating all currently available HepA and HepB vaccines. Findings may inform hepatitis vaccination programming.
成年人对多剂量疫苗接种方案的依从性差，而甲型肝炎（Hep）A 和 B 疫苗推荐用于成年人，这导致美国高危成年人中甲型肝炎和乙型肝炎的负担仍然很大。关于肝炎疫苗系列的依从性、完成情况、完成及时性以及与这些结果相关的因素的证据有限，并且不容易推广到美国成年人。这项回顾性观察性研究在一个大型的、具有地理代表性的美国成年人样本中，检查了依从性、完成情况及其及时性，以及社会人口统计学和临床因素对这些结果的影响。我们分析了 Optum Clinformatics SES 行政索赔数据库（2010 年 1 月 1 日至 2020 年 6 月 30 日）中接受 2 剂（HepA、HepB2）或 3 剂（HepB3、HepAB）肝炎疫苗的受种者的数据。依从性定义为在标签推荐的时间范围内接受加强剂量。完成情况（所有剂量的接受情况）在 6、12、18 和 24 个月时进行评估。该研究包括 356828 名年龄在 19 岁及以上的成年人，他们在指数日期（首次观察到疫苗剂量）之前和之后的 1 个月（HepB2）、6 个月（HepB3；HepAB）或 18 个月（HepA）内连续参加了一项医疗福利计划。依从性和 24 个月的完成率分别为：HepA（27.0%，28.4%）、HepB2（32.2%，44.8%）、HepB3（14.3%，37.3%）、HepAB（15.3%，33.8%）。HepB2 疫苗的完成曲线在大约 6 个月后趋于平稳，HepA、HepB3 和 HepAB 疫苗的完成曲线在大约 12 个月后趋于平稳。Logistic 回归分析表明，依从性/完成率低的风险通常与男性性别、年龄较小、黑人和西班牙裔种族/民族、较低的教育或家庭收入水平以及更多的合并症有关。所有肝炎疫苗系列的依从性和完成率都较低，尤其是男性、年轻成年人、社会经济地位较低和合并症较多的人群。据我们所知，这是对美国成年人接种所有现有的甲型肝炎和乙型肝炎疫苗的依从性和完成率的最大规模的基于索赔的分析。研究结果可能为肝炎疫苗接种规划提供信息。
