Effectiveness of a Personal Vaccination Recommendation Letter to Liver Transplant Patients and Family Physicians for Improving the Vaccination Status

Background Vaccination rates of immunosuppressed liver transplant recipients need to improve. We compared the effectiveness of a three‐arm randomized intervention on vaccination rates in liver transplant recipients. Methods Two hundred and eighty‐nine liver transplant recipients were randomly assigned to three groups: (1) patient intervention, (2) family physician intervention, and (3) combined patient and family physician intervention. The intervention consisted of a yellow information letter, which was personalized and sent to either the patient (1), the family physician (2), or both (3) in December 2016. Results Irrespective of the assigned intervention group, a significant increase in vaccination rates from baseline to follow‐up after 2 years was observed for tetanus (53%–56%), pertussis (52%–57%), hepatitis A (44%–49%), hepatitis B (64%–71%), pneumococci (68%–75%), and the sequential pneumococcal vaccination (12%–22%). Comparing the interventions, the vaccination rate for hepatitis A was significantly higher at follow‐up for intervention (3) (OR = 9.07, p = 0.043) and (2) (OR = 9.91, p = 0.034) than for intervention (1). Concerning the vaccination rate for hepatitis B, an odds ratio of 9.13 was observed for intervention (2) ( p = 0.006) compared to (1). Interventions (2) and (3) were generally superior to the patient‐centered intervention alone, with the exception of influenza vaccination. Conclusion The results show the importance of family physicians in improving vaccination rates in liver transplant recipients. Establishing low‐threshold communication channels, for example, via the electronic patient record, could improve cooperation between physicians in specialized outpatient clinics and family physicians. Trial Registration German Clinical Trials Register (DRKS: DRKS00035422). Registration was done retrospectively due to time constraints and lack of human resources.