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APHA Scientific Session and Event Listing

Recorded presentation

Robert Heimer, Ph D¹, Lauretta E. Grau, Ph D¹, Greg Scott, Ph D², Merrill Singer, Ph D³, Patricia A. Marshall, Ph D⁴, Karen H. Seal, M D, M P H⁵, and Yiqing Hu⁶. (1) Department of Epidemiology and Public Health, Yale University, PO Box 208034, 60 College St., New Haven, CT 06520, 203-785-6732, robert.heimer@yale.edu, (2) Sociology Department, DePaul University, 990 W. Fullerton Ave., Rm. 1118, Chicago, IL 60614, (3) Hispanic Health Council, 175 Main St., Hartford, CT 06106, (4) Center for Biomedical Ethics, Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH 44106-4976, (5) Department of Medicine, University of California San Francisco, San Francisco VA Medical Center, 4150 Clement St., San Francisco, CA 94121, (6) School of Public Health, Yale University, 60 College Street, New Haven, CT 06520

Purpose: This session presents the findings from a 3-year, 3-city study that investigated the provision of hepatitis B vaccination to injection drug users (IDUs) through syringe exchange programs (SEPs). Background: HBV is a vaccine-preventable disease endemic in IDUs. Despite the availability of a safe and effective vaccine for nearly a quarter of a century, vaccination rates among susceptible IDUs are all but universally less than 10%. This can only be attributed to neglect, stigma, and marginalization. Methods: We identified from the existing literature of pilot HBV vaccinations programs targeting IDUs an ideal strategy for recruiting IDUs and retaining them long enough to administer the requisite three doses of vaccine. To optimize the impact of vaccination, we used the Twinrix® formulation that immunizes against both hepatitis A and B viruses. Study Hypotheses: Our vaccination program was designed to test a set of hypotheses: (1) that an accelerated schedule for dosing would result in a higher rate for completing the 3-dose vaccine series, (2) that the accelerated schedule would result in a higher overall immunization rate, (3) that SEP customers would have a higher completion rate than non-customers, (4) that participants would understand the risks and benefits of the study provided through informed consent, (5) that desire for reimbursement was more important than health protection in predicting vaccination completion, and (6) that vaccinating IDUs using this strategy is cost effective.

Learning Objectives:

• This seesion will familiarize attendees with the results of a three-year, three-city, multidisciplinary study to optimize the targeting of vaccination against HBV to injection drug users.

Keywords: Hepatitis B, Injection Drug Users

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation