Michael Bebawy, DO1, Rohan Karkra, MBBS1, Mahinaz Mohsen, MD1, Menna-Allah Elaskandrany, DO2, Salil Chowdhury, MD1, Ahmed Al-Khazraji, MD1 1Rutgers New Jersey Medical School, Newark, NJ; 2Lenox Hill Hospital, Northwell Health, New York, NY Introduction: Patients with cirrhosis and HIV are at increased risk for severe complications from Hepatitis A virus (HAV) infection. Despite national recommendations for HAV vaccination in these high-risk populations, uptake remains suboptimal. This QA/QI project aimed to evaluate and improve HAV vaccination rates at an academic outpatient setting through targeted interventions. Methods: We conducted a retrospective and prospective analysis of HAV vaccination practices at three primary care clinics within University Hospital. Adult patients with a diagnosis of cirrhosis or HIV seen between October 2023 and October 2024 were reviewed. In November 2024, a two-part intervention was implemented: (1) an educational email outlining HAV vaccination guidelines was sent to Internal Medicine residents, and (2) “Hepatitis A Vaccination” was added to the EMR health maintenance section. Post-intervention data were collected for patients seen between December 2024 and February 2025. Outcomes included rates of HAV serologic testing, vaccination documentation, and planned vaccination.
Results: Among cirrhosis patients seen in the IM clinic, the proportion with unaddressed vaccination decreased from 25% pre-intervention to 8% post-intervention (p = 0.11). Additionally, 8% of patients post-intervention had documented plans for vaccination compared to 0% pre-intervention. In contrast, HIV patients showed a significant decline in HAV serologic testing post-intervention (64% to 38%, p = 0.012), and a reduction in documented immunity (48% to 25%, p = 0.025), likely reflecting documentation or sampling differences.
Discussion: A dual intervention involving provider education and EMR modification led to modest improvements in HAV vaccination practices for cirrhosis patients but had mixed results in the HIV population. Further efforts are needed to ensure guideline adherence across clinical settings.
Figure: Figure 1: Comparison of HAV Vaccination Metrics in Patients with Cirrhosis
Figure: Figure 2: Comparison of HAV Vaccination Metrics in Patients with HIV
Disclosures: Michael Bebawy indicated no relevant financial relationships. Rohan Karkra indicated no relevant financial relationships. Mahinaz Mohsen indicated no relevant financial relationships. Menna-Allah Elaskandrany indicated no relevant financial relationships. Salil Chowdhury indicated no relevant financial relationships. Ahmed Al-Khazraji indicated no relevant financial relationships.
Michael Bebawy, DO1, Rohan Karkra, MBBS1, Mahinaz Mohsen, MD1, Menna-Allah Elaskandrany, DO2, Salil Chowdhury, MD1, Ahmed Al-Khazraji, MD1. P5961 - Improving Hepatitis A Vaccination Rates in Cirrhosis and HIV Populations: A QA/QI Initiative at an Academic Center, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.
