{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T01:01:11Z","timestamp":1794013271208,"version":"4.8.0"},"reference-count":18,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2024,5,14]],"date-time":"2024-05-14T00:00:00Z","timestamp":1715644800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Importance: Hepatitis B is a serious problem in the United States (US), with up to 2.4 million Americans living with a chronic infection. Only 26\u201332% of people living with hepatitis B in the US are diagnosed. Additionally, just 30% of all adults are vaccinated against the virus. In 2022, the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention (CDC) updated adult hepatitis B vaccination recommendations to include all adults aged 19\u201359 years and those 60 years and older with risk factors for hepatitis B. Subsequently, in 2023, the CDC recommended that all adults be screened at least one time in their lives. Observations: Electronic health record (EHR) tools (prompts, order sets, etc.) have proven to be an effective method of increasing hepatitis B screening and vaccination, but longstanding challenges and questions around hepatitis B vaccines and tests could prevent effectual EHR implementation. As the new recommendations directly impact providers who may have limited familiarity with hepatitis B, guidance on how to identify eligible patients and triggers, order sets to facilitate vaccine\/test selection, and proper documentation and patient follow-up is necessary. Conclusions and Relevance: This communication offers a practical framework for health systems to build an effective EHR strategy for the updated adult hepatitis B recommendations. We also provide comprehensive responses to clinicians\u2019 questions that are frequently asked prior to screening or vaccinating for hepatitis B.<\/jats:p>","DOI":"10.3390\/vaccines12050536","type":"journal-article","created":{"date-parts":[[2024,5,14]],"date-time":"2024-05-14T08:59:37Z","timestamp":1715677177000},"page":"536","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Implementing Adult Hepatitis B Immunization and Screening Using Electronic Health Records: A Practical Guide"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6710-9666","authenticated-orcid":false,"given":"H. Nina","family":"Kim","sequence":"first","affiliation":[{"name":"Division of Allergy & Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA 98104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly L.","family":"Moore","sequence":"additional","affiliation":[{"name":"Immunize.org, St. Paul, MN 55116, USA"},{"name":"Department of Health Policy, Vanderbilt School of Medicine, Nashville, TN 37232, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David L.","family":"Sanders","sequence":"additional","affiliation":[{"name":"Immunize.org, St. Paul, MN 55116, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michaela","family":"Jackson","sequence":"additional","affiliation":[{"name":"Hepatitis B Foundation, Doylestown, PA 18902, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1968-2104","authenticated-orcid":false,"given":"Chari","family":"Cohen","sequence":"additional","affiliation":[{"name":"Hepatitis B Foundation, Doylestown, PA 18902, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Andrews","sequence":"additional","affiliation":[{"name":"Houston Viral Hepatitis Task Force, Houston, TX 77040, USA"},{"name":"Advisory Panel, Hep B United, Doylestown, PA 18902, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilla S.","family":"Graham","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA 02215, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,14]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2023, November 16). Global Hepatitis Report 2017. Available online: https:\/\/www.who.int\/publications\/i\/item\/9789241565455."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1052","DOI":"10.1111\/jvh.12735","article-title":"Racial\/ethnic disparities in the prevalence and awareness of Hepatitis B virus infection and immunity in the United States","volume":"24","author":"Kim","year":"2017","journal-title":"J. Viral Hepat."},{"key":"ref_3","unstructured":"Coalition for Global Hepatitis Elimination (2023, November 16). USA National Hepatitis Elimination Profile. Coalition for Global Hepatitis Elimination. Available online: https:\/\/www.globalhep.org\/sites\/default\/files\/content\/national_profiles\/files\/2024-01\/National%20Hepatitis%20Elimination%20Profile%20-USA-2023%20update-Oct23.pdf."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15585\/mmwr.ss7003a1","article-title":"Surveillance of Vaccination Coverage Among Adult Populations\u2014United States, 2018","volume":"70","author":"Lu","year":"2021","journal-title":"MMWR Surveill. Summ."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"477","DOI":"10.15585\/mmwr.mm7113a1","article-title":"Universal Hepatitis B Vaccination in Adults Aged 19\u201359 Years: Updated Recommendations of the Advisory Committee on Immunization Practices\u2014United States, 2022","volume":"71","author":"Weng","year":"2022","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15585\/mmwr.rr7201a1","article-title":"Screening and Testing for Hepatitis B Virus Infection: CDC Recommendations\u2014United States, 2023","volume":"72","author":"Conners","year":"2023","journal-title":"MMWR Recomm. Rep."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1313","DOI":"10.1093\/jamia\/ocad083","article-title":"Effectiveness of non-interruptive nudge interventions in electronic health records to improve the delivery of care in hospitals: A systematic review","volume":"30","author":"Raban","year":"2023","journal-title":"J. Am. Med. Inform. Assoc."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1587","DOI":"10.1353\/hpu.2018.0114","article-title":"Assessing the Impact of Electronic Health Record Interventions on Hepatitis B Screening and Vaccination","volume":"29","author":"Weir","year":"2018","journal-title":"J. Health Care Poor Underserved"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1007\/s11606-017-4046-6","article-title":"Using Active Choice Within the Electronic Health Record to Increase Influenza Vaccination Rates","volume":"32","author":"Patel","year":"2017","journal-title":"J. Gen. Intern. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1056\/NEJMp1712984","article-title":"Nudge Units to Improve the Delivery of Health Care","volume":"378","author":"Patel","year":"2018","journal-title":"N. Engl. J. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15585\/mmwr.rr6701a1","article-title":"Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices","volume":"67","author":"Schillie","year":"2018","journal-title":"MMWR Recomm. Rep."},{"key":"ref_12","unstructured":"Centers for Disease Control and Prevention (2024, January 24). Recommended Adult Immunization Schedule for Ages 19 Years or Older 2024. Centers for Disease Control and Prevention. 2023, Volume 5, Available online: https:\/\/www.cdc.gov\/vaccines\/schedules\/downloads\/adult\/adult-combined-schedule.pdf."},{"key":"ref_13","unstructured":"Centers for Disease Control and Prevention (2024, February 13). Interpretation of Hepatitis B Serologic Test Results. CDC. www.cdc.gov. Published 3 March 2023, Available online: http:\/\/www.cdc.gov\/hepatitis\/hbv\/interpretationOfHepBSerologicResults.htm."},{"key":"ref_14","unstructured":"Cororran, M., Spach, D., and Kim, H.N. (2024, February 13). Core Concepts\u2014HBV Screening, Testing, and Diagnosis\u2014Screening and Diagnosis\u2014Hepatitis B Online. www.hepatitisb.uw.edu. Published 13 March 2023. Available online: http:\/\/www.hepatitisb.uw.edu\/go\/screening-diagnosis\/diagnosis-hbv\/core-concept\/all."},{"key":"ref_15","unstructured":"Yarmuth, J.A. (2024, January 24). Inflation Reduction Act of 2022, Available online: https:\/\/www.congress.gov\/bill\/117th-congress\/house-bill\/5376."},{"key":"ref_16","unstructured":"National Adult and Influenza Immunization Summit (2024, January 24). Insurance Coverage of Adult Immunizations. National Adult and Influenza Immunization Summit. Available online: https:\/\/www.izsummitpartners.org\/content\/uploads\/NAIIS_vaccine-insurance-coverage_2023.pdf."},{"key":"ref_17","unstructured":"National Adult and Influenza Immunization Summit (2023, November 16). Implementing Hepatitis B Universal Adult Screening and Vaccination: Clinical Answers for Healthcare Professionals. National Adult and Influenza Immunization Summit. Available online: https:\/\/www.immunize.org\/wp-content\/uploads\/catg.d\/p2080.pdf."},{"key":"ref_18","unstructured":"Centers for Disease Control and Prevention (2024, January 24). Timing and Spacing of Immunobiologics: General Best Practice Guidelines for Immunization. www.cdc.gov. Published 19 September 2023, Available online: https:\/\/www.cdc.gov\/vaccines\/hcp\/acip-recs\/general-recs\/timing.html#unknown."}],"container-title":["Vaccines"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-393X\/12\/5\/536\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:41:53Z","timestamp":1760107313000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-393X\/12\/5\/536"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,14]]},"references-count":18,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2024,5]]}},"alternative-id":["vaccines12050536"],"URL":"https:\/\/doi.org\/10.3390\/vaccines12050536","relation":{},"ISSN":["2076-393X"],"issn-type":[{"value":"2076-393X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,14]]}}}