Adherence to Hepatitis B Virus Vaccination At Syringe Exchange Sites

Abstract

Injection drug users (IDUs) are at high risk for hepatitis B virus (HBV); however, they often do not receive preventive vaccination. IDUs who use mobile health care services linked to a syringe exchange program in New Haven were routinely screened for HBV, hepatitis C virus, and syphilis. Individuals without prior exposure to HBV were offered three-part vaccination series. Of the 212 IDUs screened for HBV infection, 134 (63%) were eligible (negative for HBV surface and core anti-bodies) for vaccination and 10 (4.7%) had evidence of chronic HBV infection. Compared to those with previous exposure to HBV, vaccine-eligible patients were significantly more likely to be younger and use heroin and less likely to be black, home-less, daily injectors, and cocaine users. Of the 134 vaccine-eligible subjects, 103 (77%) and 89 (66%) completed two and three vaccinations, respectively. Correlates of completing all three vaccinations included older age (OR = 1.06, 95% CI = 1.04-1.07), injecting daily (OR = 2.12, 95% CI = 1.36-6.73), and being homeless (OR = 1.98, 95% CI = 1.14-12.27). These results suggest that IDUs remain at high risk for acquiring HBV infection. Programs that link health care to a syringe exchange program are effective ways to provide preventive health care services to IDUs, particularly HBV vaccination. Trust engendered by and mutual respect afforded by such programs result in repeated encounters by active IDUs over time.

Ongoing susceptibility to hepatitis B virus infection among people who inject drugs in Sydney

“…[31][32][33][34][35][36] While targeted vaccination has been recommended in Australia since 1988, previous studies reported low coverage, between 26% and 33% of PWID in south-western Sydney, 13 inner-city Sydney 10,24 and in inner-suburban Melbourne. 12 Recent efforts have focused on contingency management 34,37,38 and enhanced outreach [39][40][41] to improve HBV vaccination uptake and completion in this group. There is some evidence that rapid schedules may be cost effective 42 for improving completion 25,43,44 although evidence of long-term immunogenicity in this group is still lacking.…”

Hepatitis B Virus Infection in US Correctional Facilities: A Review of Diagnosis, Management, and Public Health Implications

“…43 Protective levels of antibody have been demonstrated after one (30-50%) or two (89%) doses of the vaccine. 44 …”

A model program for hepatitis B vaccination and education of schoolchildren in rural China

“…Of the children included in the immunization program, 99.4% completed the full three-shot hepatitis B vaccine series-a rate substantially higher than the 89.9% completion rate reported for newborns in China (Centers for Disease Control and Prevention (CDC) 2007), as well as high-risk populations in the United States (Louther et al 1998;Doebbeling et al 1996;Altice et al 2005;Campbell et al 2007;Sansom et al 2003;Chang et al 2009). The high completion rate in our vaccination program is likely attributable in part to the diverse coalition of partners in this project, including academics, private foundations, local and national CDC divisions, health and education departments, hospitals, schools, and the provincial government, which maximized the knowledge base, reach, and public recognition and trust of the program.…”