Academic journal article Journal of Drug Issues

Hepatitis B Virus Prevalence and Vaccination Rates among Hispanic Injection Drug Users Participating in a Vaccination Campaign

Academic journal article Journal of Drug Issues

Hepatitis B Virus Prevalence and Vaccination Rates among Hispanic Injection Drug Users Participating in a Vaccination Campaign

Article excerpt

Injection drug users are at high risk for hepatitis B virus infections. Nevertheless, few concerted efforts have been made to provide injectors with access to an available, safe, and effective vaccine. A campaign to screen and vaccinate injectors was conducted at syringe exchange programs in Chicago, Illinois, and Hartford and Bridgeport, Connecticut. Injectors with no evidence of past hepatitis B infection were eligible for vaccination. Eligible injectors were offered the three doses of vaccine and questioned about their past and current drug use, their sociodemographics, their understanding of hepatitis infections, and their motivation for participating in the study. Disease prevalence, vaccination rates, and the answers to study questions were analyzed comparing the sample of Hispanic to non-Hispanic injectors. We screened 1970 injectors, 860 of whom were eligible for vaccination. Of those, 591 received at least one dose of the vaccine. Hispanics comprised 30.9% of those screened, 24.9% of those eligible, and 25.2% of those receiving at least one dose. Hispanics were more likely than non-Hispanic Whites or non-Hispanic Blacks to have already been infected with hepatitis B-55.6% for Hispanics versus 46.5% for non-Hispanics. Although it is impossible to generalize from our study population to Hispanic injectors as a whole, it seems apparent that if greater efforts are made to promote hepatitis B vaccination among Hispanics, high rates of vaccination can be achieved.

INTRODUCTION

Hepatitis B virus (HBV) is a vaccine-preventable infection, and national immunization efforts have significantly decreased the HBV incidence rate (Wasley, Miller, & Finelli, 2006). Nevertheless, certain groups appear to lag in the efforts to reach the goal of universal vaccination. Among these groups are injection drug users (IDUs), the risk group with the highest incidence rate. Given that Hispanics in the U.S. have generally lower than average rates for many vaccinations (Darling, Barker, Shefer, & Chu, 2005; Larson, 2003; Lees, Wortley, & Coughlin, 2005; Winston, Wortley, & Lees, 2006), it is particularly pertinent to explore the extent of HBV infection and vaccination among Hispanic IDUs.

HBV was shown to be the major etiologic agent of serum hepatitis in the late 1960s. A percentage of those infected with HBV, ranging from 20% of those infected as young children to 5% of those infected as adults, go on to develop chronic infection (Nelson & Masters Williams, 2007). Population-based surveys of the United States from the 1990s indicated that the prevalence of HBV infection was slightly higher than 5% (McQuillan et al., 1999). Surveillance of infections has detected more than 525,000 acute infections since record keeping began in 1966. At present, the incidence of acute HBV infection in the United States population as a whole is highest in non-Hispanic blacks (2.9 per 100,000) and lowest in Hispanics (1.0 per 100,000) despite lower than average rates of immunization (Wasley et al., 2006). The discovery of HBV led to an increase in the number of reported HBV incident infections, but also to the implementation of steps to reduce transmission. Since the mid-198Os the incidence of acute HBV infections in the Unites States has declined from a high of 26,654 cases in 1985 to 6,212 cases in 2004 (Wasley et al., 2006). Screening of the blood supply to prevent HBV transmission through transfusions and blood products began in 1973. The first effective vaccine became available in 1982, and vaccine efficacy has continued to improve, especially with the introduction of safe, reliable vaccines based on recombinant DNA technology (André, 1989). An aggressive campaign to provide children and adolescents universal immunization against HBV was begun in the 1990's. By 2004, greater than 92% of children, ages 19-35 months, had been fully vaccinated, receiving the established three-dose vaccine regimen (Centers for Disease Control and Prevention [CDC], 2005). …

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