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

doi:10.1111/add.13944

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

Research output: Contribution to journal › Article › peer-review

25 Citations (Scopus)

390 Downloads (Pure)

Abstract

Background 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.

Setting: Services providing injecting equipment and drug treatment, and street sites, in Glasgow (1993-2002) and across Scotland (2008-2014).

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 16-20% in 1993-99 to 52-59% in 2001-2014 (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 2·91, 95% CI 2·23-3·79). The prevalence of anti-HBc and HBsAg in Scotland was 2·6% 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 (0·60, 0·37-0·97) and current (0·40, 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 language	English
Pages (from-to)	80-90
Number of pages	11
Journal	Addiction
Volume	113
Issue number	1
Early online date	15 Jul 2017
DOIs	https://doi.org/10.1111/add.13944
Publication status	Published - 11 Dec 2017

Keywords

hepatitis B
injecting drug use
prison
vaccination
immunisation

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1111/add.13944

Author Accepted ManuscriptAccepted author manuscript, 1.05 MB

Cite this

@article{a8a4ddfdd02844a8bd4be3de83b24361,

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

abstract = "Background 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.Setting: Services providing injecting equipment and drug treatment, and street sites, in Glasgow (1993-2002) and across Scotland (2008-2014).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 16-20% in 1993-99 to 52-59% in 2001-2014 (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 2·91, 95% CI 2·23-3·79). The prevalence of anti-HBc and HBsAg in Scotland was 2·6% 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 (0·60, 0·37-0·97) and current (0·40, 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.",

keywords = "hepatitis B, injecting drug use, prison, vaccination, immunisation",

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

note = "Funding: none.",

year = "2017",

month = dec,

day = "11",

doi = "10.1111/add.13944",

language = "English",

volume = "113",

pages = "80--90",

journal = "Addiction",

issn = "0965-2140",

publisher = "Wiley-Blackwell",

number = "1",

}

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 - Funding: none.

PY - 2017/12/11

Y1 - 2017/12/11

N2 - Background 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.Setting: Services providing injecting equipment and drug treatment, and street sites, in Glasgow (1993-2002) and across Scotland (2008-2014).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 16-20% in 1993-99 to 52-59% in 2001-2014 (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 2·91, 95% CI 2·23-3·79). The prevalence of anti-HBc and HBsAg in Scotland was 2·6% 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 (0·60, 0·37-0·97) and current (0·40, 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 - Background 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.Setting: Services providing injecting equipment and drug treatment, and street sites, in Glasgow (1993-2002) and across Scotland (2008-2014).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 16-20% in 1993-99 to 52-59% in 2001-2014 (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 2·91, 95% CI 2·23-3·79). The prevalence of anti-HBc and HBsAg in Scotland was 2·6% 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 (0·60, 0·37-0·97) and current (0·40, 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

U2 - 10.1111/add.13944

DO - 10.1111/add.13944

M3 - Article

C2 - 28710874

SN - 0965-2140

VL - 113

SP - 80

EP - 90

JO - Addiction

JF - Addiction

IS - 1

ER -

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

Abstract

Keywords

UN SDGs

Access to Document

Fingerprint

Cite this