Hepatitis B vaccination for sex workers: do outreach programmes perform better?

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Vaccinology

Background:

• Hepatitis B virus (HBV) remains a significant public health concern, particularly among high-risk populations.
• Sex workers often face barriers to accessing routine healthcare, leading to lower vaccination coverage.
• Assessing the effectiveness of different vaccination strategies is crucial for disease prevention.

Purpose of the Study:

• To evaluate the success of hepatitis B vaccination for sex workers in Ghent, Belgium, using existing health services.
• To compare the effectiveness of outreach programs versus routine services for hepatitis B vaccination in this population.
• To analyze and compare two different hepatitis B vaccination schedules within an outreach program.

Main Methods:

• Assessed HBV markers in 1096 sex workers upon first contact within an outreach program.
• Measured the success of routine hepatitis B vaccination services by analyzing vaccination uptake.
• Evaluated outreach program performance by tracking initiated vaccinations and completion rates for different vaccine schedules.

Main Results:

• Only 7% of sex workers were vaccinated against hepatitis B through existing services, with 11.9% having naturally acquired HBV.
• An outreach program achieved significantly higher vaccination rates: 82.8% received the first dose and 71.5% the second.
• Vaccination completion rates were higher with shorter intervals between doses (67.9% for third dose at 1 month vs. 47.9% at 6 months).

Conclusions:

• Existing healthcare services are largely unsuccessful in achieving adequate hepatitis B vaccination coverage among sex workers.
• Targeted outreach services demonstrate superior effectiveness in vaccinating this high-risk group.
• Optimizing vaccination schedules with shorter intervals between doses improves patient compliance and vaccination completion.