ABSTRACT
Introduction: Incarcerated populations with HCV are at high risk of contracting COVID-19 disease and COVID-19-induced liver injury, causing significant morbidity and mortality. Despite the availability of vaccines, vaccine hesitancy among these populations remains a problem. Unfortunately, few studies discussed COVID-19 vaccination rates among HCV-positive prisoners. To identify subgroups that will require more interventions to prevent COVID-19, this study will assess the association between COVID-19 vaccination rates and the degree of hepatic impairment among HCV-positive prisoners. Research Question or Hypothesis: HCV-positive prisoners are more likely to receive COVID-19 vaccine if they have advanced liver disease compared to HCV-positive prisoners without hepatic impairment. Study Design: Retrospective chart review at the Illinois Department of Corrections (IDOC) HCV Clinic. Method(s): Patients seen between 12/11/2020 to 1/10/2022 were evaluated. Eligible IDOC patients included if >18 years old, had a documented COVID-19 vaccination status, and were eligible for HCV treatment. Vaccination status, FibroScan scores, abdominal ultrasound, and APRI were collected to determine if there is an association between COVID-19 vaccination rates and degree of hepatic impairment. Estimates and odds ratios were assessed using continuous and categorical variables, respectively. P-values determined statistical significance. Result(s): This IRB approved study including 336 patients showed no significant associations between the degree of hepatic impairment and COVID-19 vaccination rates using the regression model for analysis. The odds of one receiving the COVID-19 vaccine are 1.24 times more likely for someone with ultrasound evidence of cirrhosis compared to one without a documented ultrasound, and 1.01 times more likely for someone with advanced fibrosis compared to one with mild fibrosis. Conclusion(s): There was a trend showing that HCV-positive prisoners with advanced liver disease were more likely to be vaccinated against COVID-19. While an association cannot be made given statistically non-significant results, education about the importance of COVID-19 vaccination among all HCV-positive prisoners, including those with minor hepatic impairment, is imperative.