Amesty S, Ompad D C, Galea S, Fuller C M, Wu Y, Koblin B, Vlahov D
College of Physicians and Surgeons, Center for Family and Community Medicine, Columbia University, New York, NY 10032, USA.
J Community Health. 2008 Jun;33(3):139-48. doi: 10.1007/s10900-007-9082-4.
Hepatitis B (HBV) vaccination coverage remains low among drug users. In 1997, ACIP made hepatitis B vaccine available for persons aged 0-18 years and many states began requiring HBV vaccination for entry into middle school; these programs might affect HBV vaccination and infection rates in younger DUs. We were interested in determining correlates of immunization among younger (<25 years) and older (25 and older) DUs.
A community-based sample of 1,211 heroin, crack, and cocaine users 18 or older was recruited from Harlem and the Bronx. We assessed previous HBV vaccination and infection and correlates using bivariate analyses.
The sample was predominantly male (74.0%), aged > or =25 years (67.1%) and Hispanic (59.9%). In terms of socioeconomic status, 57.1% had less than a high school education, 84.5% had been homeless in their lifetime, and 48.0% had an illegal main income source. Among 399 DUs younger than 25 years of age, 30% demonstrated serological evidence of previous vaccination, 49.9% were susceptible to HBV at baseline, and 20% showed evidence of infection. In our model, previous HBV infection and vaccination status were associated with being 22 years old or younger (AOR = 1.40 and 1.66). Compared to susceptible individuals, those vaccinated were significantly less likely to be born in other countries (AOR = 0.50). Among 812 DUs 25 and older, 10.6% demonstrated serological evidence of previous vaccination, 59.2% were susceptible to HBV at baseline, and 30.2% showed evidence of infection.
Existing interventions to increase HBV vaccination among adolescents should target high risk groups.
吸毒者中乙肝疫苗接种率仍然很低。1997年,美国预防接种咨询委员会(ACIP)将乙肝疫苗提供给0至18岁人群,许多州开始要求进入中学的学生接种乙肝疫苗;这些项目可能会影响年轻吸毒者的乙肝疫苗接种率和感染率。我们有兴趣确定年轻(<25岁)和年长(25岁及以上)吸毒者免疫接种的相关因素。
从哈莱姆和布朗克斯招募了1211名18岁及以上的海洛因、快克和可卡因使用者作为基于社区的样本。我们使用双变量分析评估了既往乙肝疫苗接种和感染情况以及相关因素。
样本主要为男性(74.0%),年龄≥25岁(67.1%),西班牙裔(59.9%)。在社会经济地位方面,57.1%的人未接受过高中教育,84.5%的人一生中有过无家可归经历,48.0%的人主要收入来源非法。在399名25岁以下的吸毒者中,30%有既往接种疫苗的血清学证据,49.9%在基线时对乙肝易感,20%有感染证据。在我们的模型中,既往乙肝感染和疫苗接种状况与22岁及以下相关(比值比分别为1.40和1.66)。与易感个体相比,接种疫苗者在其他国家出生的可能性显著降低(比值比=0.50)。在812名25岁及以上的吸毒者中,10.6%有既往接种疫苗的血清学证据,59.2%在基线时对乙肝易感,30.2%有感染证据。
现有的增加青少年乙肝疫苗接种的干预措施应针对高危人群。