Acceptability of hepatitis B vaccine among drug users in a community-based sample

The prevalence of hepatitis B virus (HBV) among drug users (DUs) is high, but vaccination coverage in this group remains low. We hypothesized that this discrepancy can be addressed through offering HBV vaccine free of charge. Methods: A community-based sample of 214 adult participants with a history of drug use consented to participate in the study where we offered free HBV vaccine to participants. Participants were not offered compensation for receiving HBV vaccine; they received counseling and information on HBV and other blood-borne diseases. We compared those who accepted HBV vaccine versus those who refused. Results: Two-thirds (65.4%) accepted and received HBV vaccine; the sample was 68% male, 49% Black, and 35% Latino; 30% of participants were older than 45 years old, and 82% were ever homeless. Acceptance of HBV vaccine was more common among those who ever used cocaine (p=.01), but less common among those who had a history of ever overdosing (p=.03) There were no other significant differences between the two groups. Conclusion: We found that offering HBV vaccine in this setting resulted in high acceptance rate (65.4%), equal or higher than rates reported in the literature, higher rates being reported on studies that provided monetary compensation for receiving the vaccine. Vaccination programs should focus on missed opportunities for vaccinating this high risk population as high acceptance rates can be achieved. Further work is needed to identify reasons for non-acceptance in a setting where immunization is free. HBV completion rates will be evaluated when data is available.