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Publication Briefs

Study Suggests Low Rates of Hepatitis Vaccination among Veterans with HCV


Hepatitis vaccination is recommended in patients with chronic liver disease. VA’s comprehensive administrative data can be used to examine the rates of hepatitis A and B vaccinations in more than 200,000 veterans infected with the hepatitis C virus (HCV) who receive VA care. This study examined VA data for 243 randomly selected veterans with HCV who received care at one VAMC between 1/95 and 4/05 to determine hepatitis A and B vaccination rates – and to validate the Current Procedural Terminology (CPT) and drug codes for hepatitis A and B vaccinations. Investigators also analyzed vaccination rates for veterans diagnosed with HCV before and after 1999 to assess the extent of vaccination practices during a time that followed the publication of major guidelines (pre-guidelines 1995-1999 and post-guidelines 2000-2005).

Findings show significantly low rates of hepatitis A and B vaccination in veterans with HCV. For example, among veterans diagnosed with HCV between 2000 and 2005 – post-guidelines – approximately 8% overall received hepatitis vaccination and 7% of those with cirrhosis were vaccinated. In veterans with HCV who did not receive hepatitis vaccinations, 66%-96% had hepatitis A or B serology checked and about one-third had negative serology indicating susceptibility to co-infection and missed opportunity for vaccination. Investigators also found that CPT or drug codes for hepatitis vaccinations in administrative data are highly predictive of vaccination in medical records. Therefore, CPT and drug codes can be used to examine more thoroughly the use of vaccination in veterans with HCV.

PubMed Logo Hachem C, Kramer J, Kanwal F, and El-Serag, H. Hepatitis vaccination in patients with hepatitis C: Practice and validation of codes at a large Veterans Administration medical centre. Alimentary Pharmacology & Therapeutics November 2008;28(9):1078-1087.

This study was partly funded by HSR&D. Drs. Hachem, Kramer, and El-Serag are part of HSR&D’s Houston Center for Quality of Care and Utilization Studies.

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HSR requires notification by HSR-funded investigators about all articles accepted for publication. These journal articles are reviewed by HSR and publication briefs or summaries are written for a select number of articles that are then forwarded to VHA Central Office leadership to keep them informed about important findings or information. Articles to be summarized are selected by HSR based on timeliness of the findings, interest of leadership, or potential impact on the organization. Publication briefs are written for only a small number of HSR published articles. Visit the HSR citations database for a complete listing of HSR articles and presentations.

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