Compliance with hepatitis B vaccination in 1175 heroin users and risk factors associated with lack of vaccine response

Abstract

A large-scale, multi-site hepatitis B vaccination programme for heroin users proved feasible and effective. The factors associated with a lack of antibody response may be useful in identifying patients who would benefit most from routine post-vaccination testing, with booster doses for non-responders. These results suggest that hepatitis B vaccination for drug users should become a routine public health practice.

Hepatitis B vaccination: An unmet challenge in the era of harm reduction programs

“…It is also very likely that the percentage of drug users actually vaccinated could be higher than the percentage of those who were positive for anti-HBs, as it has been shown that HCV-and HIV-infected persons have lower levels of protection even when special vaccination schedules are applied (Quaglio et al, 2002;Wiedmann et al, 2000)and the percentages of IHUs infected with both viruses were higher than 66% and 20%, respectively, in our study. The analysis of missed opportunities for vaccination was based on self-reports, which probably resulted in some underestimation, especially with regard to lifetime opportunities, because users tend not to remember very precisely all the health services they have used.…”

Poor validity of self-reported HBV vaccination among young heroin users in Spain supports the policy “don’t ask, draw a blood sample, vaccinate and try to schedule another visit”

“…sis was restricted to those who declared they had received three or more doses, even though the validity was higher, it was still unacceptable. A second explanation could be that a large proportion of those studied were infected with HIV (17.9%) or HCV (51%), and these individuals are known to have a diminished immune response (Lum et al, 2003;Quaglio et al, 2002). This reason could explain part of the disagreement.…”

Long-Term Effectiveness of Accelerated Hepatitis B Vaccination Schedule in Drug Users

“…This was in contrast to a decreased seroprotection achievement by older drug users, as reported by previous studies. 20,24 Thus, it could be speculated that although achieving seroprotection is difficult with increasing age, seroprotection was probably long term when achieved at an older age and less likely to be lost because of immune maturity. Increasing age is an important factor in immune response to HBV vaccination and should be examined further.…”

“…Other studies also documented that HCV infection at enrollment might be a risk factor for lack of seroconversion following hepatitis B vaccination. 24,27,28 This might be explained by the fact that the participant might have high-risk behaviors for acquiring HBV and HCV infections, or a compromised immune status because of HCV infection that makes them more vulnerable to developing HBV infection. We could not explore this association further because of the secondary nature of this study.…”