Use of hepatitis B vaccination for adults with diabetes mellitus: recommendations of the Advisory Committee on Immunization Practices (ACIP).

Publisher: U.S. Centers for Disease Control Country of Publication: United States NLM ID: 7802429 Publication Model: Print Cited Medium: Internet ISSN: 1545-861X (Electronic) Linking ISSN: 01492195 NLM ISO Abbreviation: MMWR Morb Mortal Wkly Rep Subsets: MEDLINE

Publication: Atlanta, GA : U.S. Centers for Disease Control
Original Publication: [Atlanta] U. S. Dept. of Health, Education, and Welfare, Public Health Service, Center for Disease Control.

Diabetes Mellitus, Type 1* ; Diabetes Mellitus, Type 2*; Hepatitis B/*prevention & control ; Hepatitis B Vaccines/*administration & dosage; Adult ; Advisory Committees ; Aged ; Cost-Benefit Analysis ; Female ; Hepatitis B/complications ; Hepatitis B/mortality ; Hepatitis B Vaccines/economics ; Humans ; Infection Control/standards ; Male ; Middle Aged ; Risk ; United States ; Young Adult

Hepatitis B virus (HBV) causes acute and chronic infection of the liver leading to substantial morbidity and mortality. In the United States, since 1996, a total of 29 outbreaks of HBV infection in one or multiple long-term-care (LTC) facilities, including nursing homes and assisted-living facilities, were reported to CDC; of these, 25 involved adults with diabetes receiving assisted blood glucose monitoring. These outbreaks prompted the Hepatitis Vaccines Work Group of the Advisory Committee on Immunization Practices (ACIP) to evaluate the risk for HBV infection among all adults with diagnosed diabetes. The Work Group reviewed HBV infection-related morbidity and mortality and the effectiveness of implementing infection prevention and control measures. The strength of scientific evidence regarding protection was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology,* and safety, values, and cost-effectiveness were incorporated into a recommendation using the GRADE system. Based on the Work Group findings, on October 25, 2011, ACIP recommended that all previously unvaccinated adults aged 19 through 59 years with diabetes mellitus (type 1 and type 2) be vaccinated against hepatitis B as soon as possible after a diagnosis of diabetes is made (recommendation category A). Data on the risk for hepatitis B among adults aged ≥60 years are less robust. Therefore, ACIP recommended that unvaccinated adults aged ≥60 years with diabetes may be vaccinated at the discretion of the treating clinician after assessing their risk and the likelihood of an adequate immune response to vaccination (recommendation category B). This report summarizes these recommendations and provides the rationale used by ACIP to inform their decision making.

Investigator: MH Sawyer; TJ Hoerger; TV Murphy; SF Schillie; D Hu; PR Spradling; KK Byrd; J Xing; ML Reilly; RA Tohme; A Moorman; EA Smith; BN Baack; RB Jiles; M Klevens; JW Ward; HS Kahn; F Zhou

0 (Hepatitis B Vaccines)

Date Created: 20111223 Date Completed: 20120201 Latest Revision: 20220408

20221213

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