| Hepatitis B vaccination (HBV) rates are low among injection drug users (IDU) despite the availability of a safe and effective vaccine. Shortening the vaccine schedule and providing the vaccine series at SEPs with modest financial compensation are proven strategies to improve HBV vaccination uptake among IDUs. The Hepatitis Vaccine Study (HVS) was a randomized trial comparing the efficacy of the standard HBV vaccination schedule (0, 1, and 6 months) to an accelerated schedule (0, 1, and 2 months). Loss to follow-up was high during the study, and a post hoc analysis was conducted to evaluate factors distinguishing completers from non-completers.;With respect to vaccination efficacy, neither the standard nor the accelerated dosing schedule proved superior based on the present evaluation. The post hoc analysis revealed the following covariates to be associated with completion of the three-dose vaccine series: accelerated vaccine schedule (aOR 1.92, 95%CI 1.34, 2.58, p=<0.001), older age (aOR 1.05, 95%CI 1.03, 1.07, p=<0.001), and higher self-rated health score (aOR 1.26, 95%CI 1.05, 1.5, p=.02). Completion was less likely for those getting syringes from SEP customers than for SEP customers (OR 0.33, 95%CI 0.19, 0.58, p=<0.001). However, improvements in completion among the accelerated group were mitigated by lower rates of reaching the threshold for immunological protection.;These findings suggest that SEPs offering hepatitis vaccination should consider minimizing the time between first and last visits; one strategy is to offer the first dose at the screening visit. Specific attention is required to encourage vaccine completion among younger and/or less healthy participants and among SEP non-customers. Drawing on peer networks to encourage completion among those receiving syringes from SEP participants may help to improve completion rates in this population. These recommendations may also be applicable to other health interventions offered at SEPs. |
PDF Full Text Request