Accelerated hepatitis B vaccination schedule among drug users: a randomized controlled trial

Area of Science:

• Public Health
• Vaccinology
• Infectious Disease Epidemiology

Background:

• Hepatitis B vaccination serves as a model for improving multidose vaccine uptake in drug-using communities.
• The Drugs, AIDS, STDs, and Hepatitis (DASH) project aimed to enhance vaccination adherence in this population.

Purpose of the Study:

• To evaluate the effectiveness of an accelerated Hepatitis B vaccination schedule compared to a standard schedule.
• To assess the impact of behavioral interventions on vaccination acceptance and adherence.

Main Methods:

• A randomized controlled trial was conducted among non-treatment-seeking drug users.
• Participants received either standard or enhanced behavioral interventions and were randomized to standard (0, 1, 6 months) or accelerated (0, 1, 2 months) vaccination schedules.
• Outcomes included 3-dose vaccine completion and seroprotection against Hepatitis B virus (HBV).

Main Results:

• 77% of participants accepted the Hepatitis B vaccine, and 75% completed the 3-dose series.
• Injection drug users (IDUs) on the accelerated schedule showed significantly higher adherence (76%) than those on the standard schedule (66%).
• No significant difference in adherence was found between behavioral intervention groups; older age, African American race, stable housing, and alcohol use predicted adherence.

Conclusions:

• The accelerated vaccination schedule is effective in improving Hepatitis B vaccination adherence among IDUs.
• This strategy can enhance vaccine completion rates in populations with historically low adherence.