Highlights • Initiation rate rose after implementation of 1st-dose reminder at intervention site. • Completion rate rose after introduction of all-dose alert at intervention site. • During the same period, the corresponding rates at control site remained stable. Abstract Objective The Advisory Committee on Immunization Practices recommends Hepatitis B (HepB) vaccine for previously unvaccinated adults <60 years with diabetes mellitus. This observational retrospective cohort study assessed the impact of implementing electronic provider reminders on HepB vaccine initiation and 3-dose series completion rates among insured adults with diabetes aged 19–59 years old. Research design and methods Difference-in-difference (DID) analyses compared changes in vaccine initiation and completion rates (ratio of the rate ratio [RRR] and 95% confidence interval [CI]) during 12 months pre- and post-implementation between intervention and control sites. We examined trends in vaccine initiation and completion rates by plotting monthly rates during the study period. We also calculated the overall HepB vaccine coverage rates with 95% CI among all adults with diabetes aged 19–59 years old at the start and end date of the study period. Results Baseline HepB vaccine initiation and completion rates were similar at both the intervention and control sites. Gender, age, and race/ethnicity distributions within both sites were similar during the 12 months pre- and post-implementation. DID analyses demonstrated statistically significant differences in the changes of the annual vaccine initiation rates (RRR: 70.7, 95% CI: 62.8–79.6) and the third dose completion rates (RRR = 18.7, 95% CI: 14.2–24.8) between the two sites. The coverage increased significantly at the intervention site while it remained low at the control site. Conclusions Use of provider reminders is highly effective in increasing both HepB vaccine initiation and series completion rates among adults with diabetes. [ABSTRACT FROM AUTHOR]

Copyright of Vaccine is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)