Public health and community based program collaboration to provide hepatitis A & B vaccinations to high risk populations

Hartford Dispensary is a Connecticut not-for-profit community based medication assisted treatment (MAT) program specializing in serving I.V. drug users who are at high risk for infectious disease to include HIV/AIDS and hepatitis A, B & C. The agency has nine (9) clinics which serve some 3,800 patients daily. As of 12/31/2011, of 3,795 patients, 1,795 or 47.2% are hepatitis C antibody positive, 76 or 2.0% Hepatitis B +; 6 or 0.2% Hepatitis A+ and 178 or 4.7 % HIV +. In a hepatitis C prevalence study conducted in 2001, more than 50% of 1,000 patients tested positive for the hepatitis C antibody. Urban patients tested were as high as 72% positive. In collaboration with the Connecticut Department of Health (DPH), the agency began a Twinrix Hepatitis A & B vaccination program in 2002. DPH initially provided free vaccine and needles. As of July 2011, 4,534 patients had started either the 6-month three (3) dose or 12- month four (4) dose Twinrix vaccine series, with 3,245 or 71.6% completing the protocol. Completion rates: gender 71% male & 73% female; ethnicity 70.7% Caucasian, 73.5% Hispanic and 67.2% African-American. The benefits of providing the vaccine in a MAT clinic include: a concentration of at-risk persons; long tern patient retention; and medical staff already in place. A key factor in facilitating collaboration was the common goal of infectious disease prevention. The costs to the program are staff time, the costs for screening for Hepatitis A, B, C; and Twinrix Vaccine and needles.