Harris Jennie L, Jones T Stephen, Buffington Joanna
RTI International, Research Triangle Park, NC 27709, USA.
Public Health Rep. 2007;122 Suppl 2(Suppl 2):42-7. doi: 10.1177/00333549071220S208.
Hepatitis B vaccination is recommended for clients of sexually transmitted disease (STD) clinics. The Healthy People 2010 goal is for 90% of STD clinics to offer hepatitis B vaccine to all unprotected clients. This report describes hepatitis B vaccination trends in six STD clinics in the United States and discusses implications for policy and practice.
We conducted a retrospective study in six STD clinics to evaluate hepatitis B vaccination. We collected data on client visits and hepatitis B vaccinations for the period 1997-2005. To compare clinics, we calculated vaccination rates per 100 client visits. We interviewed staff to explore factors associated with hepatitis B vaccination trends.
STD clinic client visits ranged from 2,883 to 23,109 per year. The median rate of hepatitis B vaccination was 28 per 100 client visits. Vaccination rates declined in all six clinics in later years, which was associated with eligibility restrictions caused by fiscal problems and increasing levels of prior vaccination. The median rate of vaccine series completion was 30%. Staff cited multiple provider- and client-level barriers to series completion.
This study shows that STD clinics can implement hepatitis B vaccination and reach large numbers of high-risk adults. Adequate funding and vaccine supply are needed to implement current federal recommendations to offer hepatitis B vaccine to adults seen in STD clinics and to achieve the Healthy People 2010 objective.
性传播疾病（STD）诊所建议为患者接种乙肝疫苗。《健康人民2010》的目标是让90%的性传播疾病诊所为所有未接种疫苗的患者提供乙肝疫苗。本报告描述了美国六家性传播疾病诊所的乙肝疫苗接种趋势，并讨论了对政策和实践的影响。
我们在六家性传播疾病诊所进行了一项回顾性研究，以评估乙肝疫苗接种情况。我们收集了1997年至2005年期间患者就诊和乙肝疫苗接种的数据。为了比较各诊所，我们计算了每100次患者就诊的疫苗接种率。我们采访了工作人员，以探讨与乙肝疫苗接种趋势相关的因素。
性传播疾病诊所每年的患者就诊人数在2883至23109人之间。乙肝疫苗接种的中位数率为每100次患者就诊28人。在后来的几年里，所有六家诊所的疫苗接种率都有所下降，这与财政问题导致的资格限制以及先前接种水平的提高有关。疫苗接种系列完成的中位数率为30%。工作人员列举了多个提供者和患者层面的系列完成障碍。
这项研究表明，性传播疾病诊所可以实施乙肝疫苗接种，并覆盖大量高危成年人。需要充足的资金和疫苗供应，以实施当前的联邦建议，为在性传播疾病诊所就诊的成年人提供乙肝疫苗，并实现《健康人民2010》的目标。
