Predictors of completion of a hepatitis B vaccination schedule in attendees at a primary health care centre
Virginia Macdonald A , Gregory J. Dore B , Janaki Amin B and Ingrid van Beek A C
A The Kirketon Road Centre, South Eastern Sydney and Illawarra Area Health Service, Sydney, NSW 2011, Australia.
B The National Centre in HIV Epidemiology and Clinical Research, University of NSW, Sydney, NSW 2010, Australia.
C Corresponding author. Email: Ingrid.VanBeek@sesiahs.health.nsw.gov.au
Sexual Health 4(1) 27-30 http://dx.doi.org/10.1071/SH06008
Submitted: 30 January 2006 Accepted: 16 June 2006 Published: 26 February 2007
Background: In Australia, rates of hepatitis B (HBV) transmission continue to be higher in certain populations, including commercial sex workers and injecting drug users (IDU). This study aims to identify rates and predictors of completion of a HBV vaccination schedule in ‘high-risk’ attendees of a primary health care centre in Sydney. Methods: All clients who attended Kirketon Road Centre, a primary health care centre located in Kings Cross, Sydney, with no evidence of HBV immunity were included in the cohort. The study design was observational with historical controls. The main outcome measure was completion of a three-dose HBV vaccine schedule in the study period. Results: Among 2085 clients who received a first vaccination, 1013 (49%) received a second and 435 (21%) received a third vaccination. Univariate analysis found that significant predictors of completion of the vaccine schedule were intention to administer an accelerated schedule (OR 1.49, P = 0.004), not being an IDU (OR 1.29, P = 0.02) and shorter time between first visit and first vaccine dose (OR 1.24, P for trend <0.0001); however, on multivariate analysis, not being an IDU was no longer a predictor of vaccine completion. Conclusion: Implementation of an accelerated vaccination schedule improved completion rates but they were still low, despite the provision of free vaccination in a service specifically targeting the needs of sex workers, IDU and other marginalised populations. Increasing HBV vaccine uptake and completion rates in Australian adults is an important public health issue not only for the prevention of HBV but also for the future application of other potential vaccines, including those against HIV and hepatitis C.
Reduction in hepatitis B related burden of disease – measuring the success of universal immunisation programs.
Commun Dis Intell
Global control of hepatitis B virus infection.
Lancet Infect Dis
National Centre in HIV Epidemiology and Clinical Research (NCHECR). HIV/AIDS, viral hepatitis and sexually transmissible infection in Australia: Annual Surveillance Report 2004. Sydney: NCHECR; 2004.
Estimates of chronic hepatitis B virus infection in Australia, 2000.
Aust N Z J Public Health
Results of an enhanced-outreach programme of hepatitis B vaccination in the Netherlands (1998–2000) among men who have sex with men, hard drug users, sex workers and heterosexual persons with multiple partners.
Occult hepatitis B virus infection in a North American adult hemodialysis patient population.
Hepatitis B virus infection and vaccination status of high risk people in Sydney: 1982 and 1991.
Med J Aust
Incidence of bloodborne virus infection and risk behaviours in a cohort of injecting drug users in Victoria, 1990–1995.
Med J Aust
The incidence of hepatitis B infection in Australia: an epidemiological review.
Med J Aust
Risk factors for hepatitis C virus infection among injecting drug users in Sydney.
Hepatitis C virus in the setting of HIV or hepatitis B coinfection.
Semin Liver Dis
Risk behaviours and antibody hepatitis B and C prevalence among injecting drug users in south-western Sydney, Australia.
J Gastroenterol Hepatol
Poor knowledge and low coverage of hepatitis B vaccination among injecting drug users in Sydney.
Aust NZ J Public Health
Comparison of the accelerated and classic vaccination schedules against Hepatitis B: three-week Hepatitis B vaccination schedule provides immediate and protective immunity.
Ann Clin Microbiol Antimicrob
Three-week hepatitis B vaccination provides protective immunity.
An accelerated schedule for young drug users.
Aust N Z J Public Health
Early anti-HBs antibody response to accelerated and to conventional hepatitis B vaccination regimens in healthy persons.
Factors influencing hepatitis B vaccine uptake in injecting drug users.
J Public Health Med
The impact of reducing dose frequency on health outcomes.
Immunogencity of 10 and 20 microgram hepatitis B vaccine in a two-dose schedule.
A randomised controlled trial of monetary incentives vs. outreach to enhance adherence to the hepatitis B vaccine series among injection drug users.
Drug Alcohol Depend