Effectiveness of Vaccine Education on Vaccine Awareness and Vaccine Uptake in Patients with Cirrhosis of Liver of a Tertiary Care Centre in South India

Background and Aim: Cirrhotic patients have increased morbidity and mortality with superimposed bacterial or viral infections. Centers for Disease Control (CDC) recommends vaccination for all chronic liver disease patients yet vaccination status among these patients is poor, and no guidelines are available in India. Hence, we aimed to study the effectiveness of vaccine education on vaccine awareness and uptake in patients with cirrhosis of liver. Method: A pilot study was undertaken among100 adults with cirrhosis of liver who were vaccine naive except for Covid-19 from October 2022 to Dec 2022. We used one group pre-test posttest design with a total enumerative sampling technique. The awareness was assessed with a validated questionnaire having maximum score of 60. The awareness level was categorized as lack of awareness (< 15), low (16-30), medium (31-45) and high-level awareness (>45). The baseline information was collected using a direct interview technique, and information about adult vaccination was given one-on-one basis by a trained nurse. A post-test was done on 7th day and immunization record was reviewed after 45 days. Data were analysed using SPSS 29.0. The study has institutional ethics committee approval. Results: The mean age of the study population was 60 years with predominantly males (81%). About 65% had comorbidities and 76% of patients had low-level awareness. The post-test interview revealed significant (p<0.00) improvement in level of awareness and vaccine uptake. The vaccination status improved from non-vaccinated to vaccinated in hepatitis B (95%), hepatitis A (76%), influenza (49%) and pneumococcal (40%). The barriers for lesser vaccine uptake of hepatitis A, influenza and pneumococcal vaccine were cost (88%), lack of insurance coverage for preventive vaccinations (61%), accessibility (42%), poor care-giver support (32%), fear or anxiety regarding vaccination (18%). Conclusion: A nurse-led awareness campaign led to significant increase in vaccine knowledge and uptake among cirrhotic patients