Abstract: SA-PO0908
Improving In-Hospital Vaccination Rates for Patients with CKD
Session Information
- Health Maintenance, Nutrition, and Metabolism
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Health Maintenance, Nutrition, and Metabolism
- 1500 Health Maintenance, Nutrition, and Metabolism
Authors
- Burgos Guntin, Eusebio Felipe, NYC Health + Hospitals / Elmhurst, Icahn School of Medicine at Mount Sinai, Queens, New York, United States
- Raman, Shakthi, NYC Health + Hospitals / Elmhurst, Icahn School of Medicine at Mount Sinai, Queens, New York, United States
- McGee, James, NYC Health + Hospitals / Elmhurst, Icahn School of Medicine at Mount Sinai, Queens, New York, United States
- Stern, Aaron S., NYC Health + Hospitals / Elmhurst, Icahn School of Medicine at Mount Sinai, Queens, New York, United States
Background
Patients with CKD are at increased risk for vaccine-preventable infections. Vaccination rates remain well below national goals. Early hepatitis B (HBV) vaccination before eGFR falls below 30mL/min/1.73m^2 yields higher seroconversion rates, and pneumococcal vaccination is recommended for all CKD stages.
Methods
Our quality improvement project aimed to increase inpatient HBV and pneumococcal vaccination rates in medicine patients with CKD by 25% in 5 months. Data were obtained via EMR search using ICD-10 codes, lab values, and vaccination orders. Eligible patients had CKD (eGFR<60 mL/min/1.73m^2) on admission, were discharged from a general medicine service, and did not require renal replacement therapy. All were pneumococcal vaccine candidates. Candidates for HBV vaccination were those without documented hepatitis B surface antibody positivity or with missing serologies, excluding those with positive surface antigen. Vaccination status was confirmed via EMR administration records.
Sequential interventions targeting internal medicine residents included (1) a short lecture highlighting indications for vaccination in CKD patients, (2) a flyer posted in all resident work rooms, and (3) a CKD dot phrase with embedded vaccination recommendations auto-shared with residents.
Results
HBV vaccination rates increased from 0% (pre-intervention) to 0.83%, then dropped again to 0% (post-lecture), 0.99 and then 1.59% (post-flyer), and 4.48% (post-dot phrase). Pneumococcal vaccination rates remained stable at 0.75–4.90% across all phases.
Conclusion
An uptrend (>25%) in HBV vaccination rates was observed after interventions, with no significant change in Pneumococcal vaccination rates. As expected, educational interventions were less effective than EMR interventions, with the largest improvement occurring with dot phrase implementation.
A limitation of this project was that denominator accuracy was limited for both vaccines: Pneumococcal vaccine candidacy could not be determined by prior vaccination status, and CKD underrecognition may have affected cohort capture. Similarly, infrequent serology testing limited HBV vaccination denominator reliability.
The latest dot phrase intervention addresses these limitations by autopopulating HBV serologies and prior pneumococcal vaccination history, and prompting residents to obtain missing data.