Chronic hepatitis B virus (HBV) infection remains a significant concern in public health, as it is associated with hepatocellular carcinoma and liver cirrhosis. Despite the availably of an effective vaccine, many individuals remain susceptible to infection in the US, especially foreign-born individuals, veterans, current or formerly incarcerated individuals, intravenous drug users (IDU), and individuals with experiences of homelessness. At various Permanent Supportive Housing (PSH) sites in South and Southeast Texas, a partnership of Community Health Workers (CHWs) and nurses offered PSH residents door-to-door, no-cost HBV testing and vaccination. Over 1,000 individuals were tested, and many who were eligible for vaccination received at least one dose of their HBV vaccine and completed their vaccination series, demonstrating the utility of this door-to-door model for an underserved population. A multivariable logistic regression was performed to determine associations between completion of vaccination series and demographic factors. Older age was shown to be predictive of completion of the HBV vaccination series (OR=1.02, p=0.001), while other factors such as gender, race, and ethnicity were not associated with series completion, which is consistent with previous research. Additionally, this low-barrier, CHW-based strategy for HBV vaccination resulted in a relatively high vaccine series completion rate (almost 30% of eligible participants), as compared to similar programs accessing at-risk populations in a non-healthcare-based setting (15% - 23%). The nursing team also faced significant vaccination challenges during the height of the COVID-19 pandemic, including interruption of vaccine delivery for one year due to the pandemic, and generalized vaccine hesitancy and fears around HBV and COVID-19 vaccine interactions, which most likely decreased our participation rate. This analysis highlights the need for low-barrier and place-based HBV vaccination programs to reduce viral hepatitis B susceptibility in at-risk US populations. Limitations to this analysis include missingness and interruptions to the data collection process, small sample size, a limited scope of variables, as well as this being a secondary analysis.

This abstract was written and will be presented by a current, State-of-Texas-certified CHW.