Hepatitis A and Hepatitis B Vaccination Coverage Among Persons Who Inject Drugs and Have Evidence of Hepatitis C Infection

Koepke, Ruth; Sill, Danielle N.; Akhtar, Wajiha Z.; Mitchell, Kailynn P; Guilfoyle, Sheila M.; Westergaard, Ryan P.; Schauer, Stephanie L.; Vergeront, James M.

doi:10.1177/0033354919874088

Cited by 22 publications

(19 citation statements)

References 28 publications

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“…25 Another study among PWID with evidence of HCV infection found higher proportions of HAV and HBV susceptibility; however, these findings were based on records of vaccination history, not serological measures. 26 Although we found that age was inversely related to HBV susceptibility, significant proportions of all age groups in our study did not have HBV immunity. The proportion of HBV susceptibility was higher among participants born during 1990-1999 than among participants born before 1990, suggesting that HBV vaccination may not be resulting in comprehensive coverage.…”

Section: Discussioncontrasting

confidence: 65%

“…1,24 Although studies on the seroprevalence of HAV and HBV susceptibility among SSP participants are limited, some studies were conducted among similar populations. 23,25,26 One study conducted among PWID found higher proportions of HAV and HBV susceptibility than our study did. 23 A study using a nationally representative sample also found higher proportions of HAV and HBV susceptibility than our study did.…”

Section: Discussioncontrasting

confidence: 62%

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Susceptibility to Hepatitis A and B Virus Among Clients at a Syringe Services Program in Philadelphia, 2018

et al. 2020

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Objectives Although many people who use drugs meet criteria for vaccination against hepatitis A virus (HAV) and hepatitis B virus (HBV), estimates of susceptibility (ie, lack of immunity) are not well established. This study sought to identify the prevalence of and characteristics associated with HAV and HBV susceptibility among people who use drugs attending an urban syringe services program. Methods We initiated this seroprevalence study in 2018 among 438 clients of a syringe services program who met study criteria, including provision of a blood specimen and a self-reported history of drug use. We assessed HAV and HBV susceptibility and infection via serological testing. We examined associations between participant characteristics and serology status by using descriptive statistics and multivariable logistic regression models. Results Of the initial 438 clients identified, 353 (80.6%) met study criteria. Of 352 participants with conclusive HAV test results, 48.6% (n = 171) were HAV susceptible; of 337 participants with conclusive HBV test results, 32.6% (n = 110) were HBV susceptible, 24.3% (n = 82) showed evidence of past or present HBV infection, and 43.0% (n = 145) had vaccine-derived immunity. Compared with participants born before 1970, participants born during 1980-1989 had 5.90 (95% CI, 2.42-14.40) times the odds of HAV susceptibility and 0.18 (95% CI, 0.06-0.53) times the odds of HBV susceptibility, and participants born during 1990-1999 had 6.31 (95% CI, 2.34-17.00) times the odds of HAV susceptibility. Decreased odds of HAV susceptibility were associated with homelessness (adjusted odds ratio = 0.48; 95% CI, 0.28-0.82). Conclusion Despite applicable HAV and HBV vaccination recommendations, substantial gaps exist in HAV and HBV susceptibility among a population of people who use drugs. These findings highlight the need for increased HAV and HBV vaccination efforts among people who use drugs.

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Section: Discussioncontrasting

confidence: 65%

Section: Discussioncontrasting

confidence: 62%

Susceptibility to Hepatitis A and B Virus Among Clients at a Syringe Services Program in Philadelphia, 2018

et al. 2020

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“…Since 1996, ACIP has recommended HepA vaccination for persons who use injection or noninjection drugs ( 6 ). Despite this longstanding recommendation, HAV seropositivity remains low (20%–40%) in this population ( 13 , 99 , 100 ).…”

Section: Hav Backgroundmentioning

confidence: 95%

Prevention of Hepatitis A Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices, 2020

Nelson¹,

Weng²,

Hofmeister³

et al. 2020

MMWR Recomm. Rep.

148

146

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Summary Hepatitis A is a vaccine-preventable, communicable disease of the liver caused by the hepatitis A virus (HAV). The infection is transmitted via the fecal-oral route, usually from direct person-to-person contact or consumption of contaminated food or water. Hepatitis A is an acute, self-limited disease that does not result in chronic infection. HAV antibodies (immunoglobulin G [IgG] anti-HAV) produced in response to HAV infection persist for life and protect against reinfection; IgG anti-HAV produced after vaccination confer long-term immunity. This report supplants and summarizes previously published recommendations from the Advisory Committee on Immunization Practices (ACIP) regarding the prevention of HAV infection in the United States. ACIP recommends routine vaccination of children aged 12–23 months and catch-up vaccination for children and adolescents aged 2–18 years who have not previously received hepatitis A (HepA) vaccine at any age. ACIP recommends HepA vaccination for adults at risk for HAV infection or severe disease from HAV infection and for adults requesting protection against HAV without acknowledgment of a risk factor. These recommendations also provide guidance for vaccination before travel, for postexposure prophylaxis, in settings providing services to adults, and during outbreaks

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“…We use the term "PWUD" referring to those who use illicit substances including opioids. While a few prior studies have examined Hepatitis A virus (HAV) and Hepatitis B virus (HBV) vaccination among PWUD in the US, these studies are often limited in geographic coverage and sample size [28][29][30]. Information on receipt of other recommended vaccinations among PWUD is limited [31].…”

Section: Introductionmentioning

confidence: 99%

Identifying Missed Opportunities for Routine Vaccination among People Who Use Drugs

Frew

Schamel

Randall

et al. 2021

IJERPH

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In the US, adult immunization coverage remains low, especially among vulnerable populations, as recent hepatitis A outbreaks have demonstrated. We studied the vaccination history variation among the US adults who use drugs by implementing a community-engaged research survey to identify reported immunization coverage, missed opportunities (MO), and places where immunizations might be delivered. Our analysis of a sample of 1127 participants recruited at community syringe exchanges in three cities identified higher overall vaccination receipt in Los Angeles compared to Atlanta or Las Vegas (e.g., HAV receipt 52.2% LA, 42.1% LV, 41.4% Atlanta). Overall, fewer participants reported having received HAV (45.9%), HBV (47.5%), or influenza (47.6%) vaccines than MMR (57.1%) or Td/Tdap (61.1%). Across sites, HAV receipt was higher for participants incarcerated ≥5 years (54.2% vs. 43.6% for those incarcerated <5 years, 49.4% no incarceration history, p = 0.02). HBV receipt was higher among participants who were not intravenous drug users (56.1% vs. 46.0%, p = 0.03). Additionally, income >$20k predicted higher rates of MMR receipt (67.0% vs. 56.5%, p = 0.009), as did stable housing (62.8% vs. 54.3%, p = 0.01). To address the need to expand vaccine coverage among vulnerable adults, delivering vaccine at sites where persons who use drugs access services, or in correctional facilities, may be warranted.

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Hepatitis A and Hepatitis B Vaccination Coverage Among Persons Who Inject Drugs and Have Evidence of Hepatitis C Infection

Cited by 22 publications

References 28 publications

Susceptibility to Hepatitis A and B Virus Among Clients at a Syringe Services Program in Philadelphia, 2018

Susceptibility to Hepatitis A and B Virus Among Clients at a Syringe Services Program in Philadelphia, 2018

Prevention of Hepatitis A Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices, 2020

Identifying Missed Opportunities for Routine Vaccination among People Who Use Drugs

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