P46 Hepatology outpatient clinics: an opportunity to improve seasonal vaccine uptake in people with liver disease?

<h3>Background and Aims</h3> Liver cirrhosis is associated with high mortality from both influenza and COVID-19 infections, as has been well demonstrated in recent large-scale studies. There is clear NICE Guidance encouraging promotion of seasonal vaccination uptake via secondary care as well as in primary care. The outpatient hepatology clinic sees many eligible people attend outpatients either as patients or carers, which provides a potential engagement opportunity to offer or promote seasonal vaccination. <h3>Method</h3> Business intelligence reports were generated for outpatient clinic appointments for hepatology clinics across three days in November 2022 at the Bristol Royal Infirmary. The audit aimed to determine the number of patients attending who were eligible for influenza vaccination and of these the number who had not received a seasonal influenza vaccine. GP records were accessed to establish vaccination status. Patients were excluded from the study if their GP records were not accessible or if they did not attend the appointment, since this would not represent a vaccination opportunity. <h3>Results</h3> 111 patients were included after exclusions. 49% of hepatology clinic attendees (n = 54/111) were eligible for influenza vaccination but had not been vaccinated (see figure 1). Most of those not eligible for vaccination were patients being managed for chronic hepatitis B infection. <h3>Conclusion</h3> This audit demonstrates that outpatient clinics in secondary care offer an opportunity to engage vulnerable populations in seasonal vaccination. Further work is needed to establish the acceptability of offering vaccination during clinic attendances for patients as well as their carers, and to determine whether this is a valuable intervention likely to capture a patient group not engaged with primary care. This is of particular relevance for people affected by health inequalities who may experience barriers to vaccination, a group well represented in hepatology outpatient clinics.