Background: Hepatitis A virus infection (HAV), hepatitis B virus infection (HBV), and tetanus are important vaccine-preventable infections among individuals with substance use disorder (SUD). 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.
Methods: In a retrospective cohort study, we included adults hospitalized at Kaiser Permanente Southern California between 2010 and 2023, with a SUD 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.
Results: Among 465,282 eligible individuals, 41.8% were female, 45.0% were non-Hispanic White, and 33.9% were Hispanic; mean age was 48.0 years (S.D 19.0). For tetanus, 329,384 (70.8%) received a booster within 10 years prior to 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 prior to first hospitalization. Among 377,774 at-risk for HAV, 1.3% were screened for immunity at any hospitalization; 0.8% initiated HAV vaccinations during a surveillance period. For HBV, 96,884 (20.8%) completed HBV vaccinations prior to 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.
Conclusions: 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.
Keywords: Substance use disorder; hepatitis A infection; hepatitis B infection; tetanus.
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