|About the Book|
Background. Injection drug users (IDUs) are at highest risk of hepatitis B virus (HBV) infection due to unsafe injection practices and unprotected sex acts. The current vaccination coverage in IDUs is low and the incidence of HBV infection in thisMoreBackground. Injection drug users (IDUs) are at highest risk of hepatitis B virus (HBV) infection due to unsafe injection practices and unprotected sex acts. The current vaccination coverage in IDUs is low and the incidence of HBV infection in this high-risk population is high. Research in public health is needed to leverage different strategies to overcome barriers to hepatitis B vaccination campaigns among IDUs. A comprehensive evaluation of the costs and benefits of such vaccination campaigns is also needed. In addition, given that universal immunization will make vaccination campaigns targeting IDUs unnecessary at some point in the future, the question of how long hepatitis B vaccination campaigns are needed for IDUs and the epidemiological impacts of such campaigns should be addressed.-Methods. Three sub-studies were conducted in this dissertation based on the Hepatitis Vaccine Study (HVS) in Chicago IL and Hartford and Bridgeport CT. Sub-Study I determined if syringe exchange programs (SEPs) are effective venues to reach and vaccinate IDUs and if an accelerated (0, 1, 2 months) hepatitis B vaccination schedule is superior to the standard (0, 1, 6 months) one in protecting IDUs against HBV infection. Sub-Study II explored whether hepatitis B vaccination targeting IDUs through SEPs is economically desirable for the healthcare system. Sub-Study III assessed the impact of hepatitis B vaccination targeting IDUs through SEPs on reducing the high HBV incidence among IDUs.-Results. Participants in the accelerated vaccination schedule were significantly more likely to complete the vaccination series compared to participants in the standard one. Hepatitis B vaccination campaigns targeting IDUs through SEPs are cost-saving from the perspective of the health care sector. Implementing a vaccination program through SEPs will be effective in reducing HBV incidence in IDUs in Chicago IL and Hartford and Bridgeport CT.-Conclusion. Existing SEPs in the United States (US) should provide hepatitis B vaccination services. The two-month accelerated schedule is recommended. Hepatitis B vaccination is necessary for controlling the HBV endemic in IDUs in the US in the future 10 years. In addition, it is economically beneficial for the health care system.