Association between universal hepatitis B prison vaccination, vaccine uptake and hepatitis B infection among people who inject drugs

Norah E. Palmateer, David J. Goldberg, Alison Munro, Avril Taylor, Alan Yeung, Lesley A. Wallace, Alan Mitchell, Samantha J. Shepherd, Rory N. Gunson, Celia Aitken, Sharon J. Hutchinson

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Abstract

Back ground and aims:In Scotland, hepatitis B virus (HBV) vaccination for all prisoners was introduced in 1999; here, we examine the impact of this programme among people who inject drugs (PWID) in the community. This study aimed to compare rates of HBV vaccine uptake before and after implementation of the prison programme and to estimate the determinants of vaccine uptake, the levels of ever/current HBV infection and the associations between vaccine uptake and ever/current HBV infection.
Design:Data collected via serial cross-sectional surveys were used to compare the proportion who reported being vaccinated over time. For the 2013-14 survey, rates of ever/current HBV infection were calculated and the associations between vaccine uptake and ever/current HBV infection were examined using logistic regression.
Settings:Services providing injecting equipment and drug treatment and street sites in Glasgow (1993-2002) and throughout Scotland (2008-14).
Participants:More than 10 000 PWID in total were recruited in the surveys.
Measurements:Participants completed a questionnaire (all years) to ascertain self-reported vaccine uptake and provided a blood spot (in 2013-14), tested for HBV core antibodies (anti-HBc) and surface antigen (HBsAg).
Findings: Among recent-onset PWID in Glasgow, vaccine uptake increased from 16% in 1993 to 59% in 2008-14 (P < 0.001). Among all PWID in Scotland, uptake increased further from 71% in 2008-09 to 77% in 2013-14 (P < 0.001) and was associated with incarceration [adjusted odds ratio (aOR) = 2.91, 95% confidence interval (CI) = 2.23-3.79]. The prevalence of anti-HBc and HBsAg in Scotland was2.6 and 0.3%, respectively, among PWID who had commenced injecting in the decade since the programme's introduction. Vaccination was associated with reduced odds of ever (aOR = 0.60, CI = 0.37-0.97) and current (aOR = 0.40, CI = 0.16-0.97) HBV infection.
Conclusions:In Scotland, uptake of hepatitis B virus (HBV) vaccination among people who inject drugs (PWID) in the community has increased since the 1999 introduction of universal prison vaccination, and current levels of HBV infection among PWID are low compared with other European countries.
Original languageEnglish
Pages (from-to)80-90
Number of pages11
JournalAddiction
Volume113
Issue number1
Early online date21 Aug 2017
DOIs
Publication statusPublished - Jan 2018

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Hepatitis B Vaccines
Prisons
Hepatitis B
Hepatitis B virus
Vaccination
Virus Diseases
Scotland
Infection
Pharmaceutical Preparations
Vaccines
Odds Ratio
Confidence Intervals
Surface Antigens
Hepatitis B Antibodies
Prisoners
Street Drugs
Cross-Sectional Studies
Logistic Models
Equipment and Supplies

Keywords

  • Hepatitis B
  • injecting drug use
  • prison
  • vaccination
  • immunisation
  • community surveys

Cite this

Palmateer, Norah E. ; Goldberg, David J. ; Munro, Alison ; Taylor, Avril ; Yeung, Alan ; Wallace, Lesley A. ; Mitchell, Alan ; Shepherd, Samantha J. ; Gunson, Rory N. ; Aitken, Celia ; Hutchinson, Sharon J. / Association between universal hepatitis B prison vaccination, vaccine uptake and hepatitis B infection among people who inject drugs. In: Addiction. 2018 ; Vol. 113, No. 1. pp. 80-90.
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abstract = "Back ground and aims:In Scotland, hepatitis B virus (HBV) vaccination for all prisoners was introduced in 1999; here, we examine the impact of this programme among people who inject drugs (PWID) in the community. This study aimed to compare rates of HBV vaccine uptake before and after implementation of the prison programme and to estimate the determinants of vaccine uptake, the levels of ever/current HBV infection and the associations between vaccine uptake and ever/current HBV infection.Design:Data collected via serial cross-sectional surveys were used to compare the proportion who reported being vaccinated over time. For the 2013-14 survey, rates of ever/current HBV infection were calculated and the associations between vaccine uptake and ever/current HBV infection were examined using logistic regression.Settings:Services providing injecting equipment and drug treatment and street sites in Glasgow (1993-2002) and throughout Scotland (2008-14).Participants:More than 10 000 PWID in total were recruited in the surveys.Measurements:Participants completed a questionnaire (all years) to ascertain self-reported vaccine uptake and provided a blood spot (in 2013-14), tested for HBV core antibodies (anti-HBc) and surface antigen (HBsAg).Findings: Among recent-onset PWID in Glasgow, vaccine uptake increased from 16{\%} in 1993 to 59{\%} in 2008-14 (P < 0.001). Among all PWID in Scotland, uptake increased further from 71{\%} in 2008-09 to 77{\%} in 2013-14 (P < 0.001) and was associated with incarceration [adjusted odds ratio (aOR) = 2.91, 95{\%} confidence interval (CI) = 2.23-3.79]. The prevalence of anti-HBc and HBsAg in Scotland was2.6 and 0.3{\%}, respectively, among PWID who had commenced injecting in the decade since the programme's introduction. Vaccination was associated with reduced odds of ever (aOR = 0.60, CI = 0.37-0.97) and current (aOR = 0.40, CI = 0.16-0.97) HBV infection.Conclusions:In Scotland, uptake of hepatitis B virus (HBV) vaccination among people who inject drugs (PWID) in the community has increased since the 1999 introduction of universal prison vaccination, and current levels of HBV infection among PWID are low compared with other European countries.",
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Association between universal hepatitis B prison vaccination, vaccine uptake and hepatitis B infection among people who inject drugs. / Palmateer, Norah E.; Goldberg, David J.; Munro, Alison; Taylor, Avril; Yeung, Alan; Wallace, Lesley A.; Mitchell, Alan; Shepherd, Samantha J.; Gunson, Rory N.; Aitken, Celia; Hutchinson, Sharon J.

In: Addiction, Vol. 113, No. 1, 01.2018, p. 80-90.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Association between universal hepatitis B prison vaccination, vaccine uptake and hepatitis B infection among people who inject drugs

AU - Palmateer, Norah E.

AU - Goldberg, David J.

AU - Munro, Alison

AU - Taylor, Avril

AU - Yeung, Alan

AU - Wallace, Lesley A.

AU - Mitchell, Alan

AU - Shepherd, Samantha J.

AU - Gunson, Rory N.

AU - Aitken, Celia

AU - Hutchinson, Sharon J.

N1 - Acceptance date from journal webpage AAM: 12m embargo (merged 2 word files)

PY - 2018/1

Y1 - 2018/1

N2 - Back ground and aims:In Scotland, hepatitis B virus (HBV) vaccination for all prisoners was introduced in 1999; here, we examine the impact of this programme among people who inject drugs (PWID) in the community. This study aimed to compare rates of HBV vaccine uptake before and after implementation of the prison programme and to estimate the determinants of vaccine uptake, the levels of ever/current HBV infection and the associations between vaccine uptake and ever/current HBV infection.Design:Data collected via serial cross-sectional surveys were used to compare the proportion who reported being vaccinated over time. For the 2013-14 survey, rates of ever/current HBV infection were calculated and the associations between vaccine uptake and ever/current HBV infection were examined using logistic regression.Settings:Services providing injecting equipment and drug treatment and street sites in Glasgow (1993-2002) and throughout Scotland (2008-14).Participants:More than 10 000 PWID in total were recruited in the surveys.Measurements:Participants completed a questionnaire (all years) to ascertain self-reported vaccine uptake and provided a blood spot (in 2013-14), tested for HBV core antibodies (anti-HBc) and surface antigen (HBsAg).Findings: Among recent-onset PWID in Glasgow, vaccine uptake increased from 16% in 1993 to 59% in 2008-14 (P < 0.001). Among all PWID in Scotland, uptake increased further from 71% in 2008-09 to 77% in 2013-14 (P < 0.001) and was associated with incarceration [adjusted odds ratio (aOR) = 2.91, 95% confidence interval (CI) = 2.23-3.79]. The prevalence of anti-HBc and HBsAg in Scotland was2.6 and 0.3%, respectively, among PWID who had commenced injecting in the decade since the programme's introduction. Vaccination was associated with reduced odds of ever (aOR = 0.60, CI = 0.37-0.97) and current (aOR = 0.40, CI = 0.16-0.97) HBV infection.Conclusions:In Scotland, uptake of hepatitis B virus (HBV) vaccination among people who inject drugs (PWID) in the community has increased since the 1999 introduction of universal prison vaccination, and current levels of HBV infection among PWID are low compared with other European countries.

AB - Back ground and aims:In Scotland, hepatitis B virus (HBV) vaccination for all prisoners was introduced in 1999; here, we examine the impact of this programme among people who inject drugs (PWID) in the community. This study aimed to compare rates of HBV vaccine uptake before and after implementation of the prison programme and to estimate the determinants of vaccine uptake, the levels of ever/current HBV infection and the associations between vaccine uptake and ever/current HBV infection.Design:Data collected via serial cross-sectional surveys were used to compare the proportion who reported being vaccinated over time. For the 2013-14 survey, rates of ever/current HBV infection were calculated and the associations between vaccine uptake and ever/current HBV infection were examined using logistic regression.Settings:Services providing injecting equipment and drug treatment and street sites in Glasgow (1993-2002) and throughout Scotland (2008-14).Participants:More than 10 000 PWID in total were recruited in the surveys.Measurements:Participants completed a questionnaire (all years) to ascertain self-reported vaccine uptake and provided a blood spot (in 2013-14), tested for HBV core antibodies (anti-HBc) and surface antigen (HBsAg).Findings: Among recent-onset PWID in Glasgow, vaccine uptake increased from 16% in 1993 to 59% in 2008-14 (P < 0.001). Among all PWID in Scotland, uptake increased further from 71% in 2008-09 to 77% in 2013-14 (P < 0.001) and was associated with incarceration [adjusted odds ratio (aOR) = 2.91, 95% confidence interval (CI) = 2.23-3.79]. The prevalence of anti-HBc and HBsAg in Scotland was2.6 and 0.3%, respectively, among PWID who had commenced injecting in the decade since the programme's introduction. Vaccination was associated with reduced odds of ever (aOR = 0.60, CI = 0.37-0.97) and current (aOR = 0.40, CI = 0.16-0.97) HBV infection.Conclusions:In Scotland, uptake of hepatitis B virus (HBV) vaccination among people who inject drugs (PWID) in the community has increased since the 1999 introduction of universal prison vaccination, and current levels of HBV infection among PWID are low compared with other European countries.

KW - Hepatitis B

KW - injecting drug use

KW - prison

KW - vaccination

KW - immunisation

KW - community surveys

U2 - 10.1111/add.13944

DO - 10.1111/add.13944

M3 - Article

VL - 113

SP - 80

EP - 90

JO - Addiction

JF - Addiction

SN - 0965-2140

IS - 1

ER -