Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, Ottawa, ON, Canada.
Hospital for Sick Kids, University of Toronto, Toronto, ON, Canada.
J Urban Health. 2010 Mar;87(2):337-348. doi: 10.1007/s11524-009-9428-6. Epub 2010 Feb 20.
In Canada, universal and publicly funded hepatitis B immunization programs have been available since 1998 in all provinces and territories. This present study estimates the proportion of having vaccine-induced immunity to hepatitis B virus (HBV) infection and its associated determinants among street-involved youth aged at 15-24 years old in Canada using the data collected by the Enhanced Surveillance of Canadian Street Youth. Vaccine-induced immunity was identified by blood test results of anti-HBc negative and anti-HBs positive. Of the 4,035 participants included in this study, the overall proportion of those with vaccine-induced immunity to HBV was 51.7% during the study period compared to over 90% among the general adolescent population. The proportion of street-involved youth immunized with HBV vaccine increased from 34.7% in 1999 to 64.4% in 2005. Immunity was higher among females (aOR = 1.43, 1.17-1.75) and among those with a reported history of sexually transmitted infection (aOR = 1.30, 1.03-1.63). The proportion of youth with the immunity decreased as age increased (aOR = 0.78, 0.76-0.81, per year increase). Despite an overall increase in the proportion of Canadian street-involved youth with vaccine-induced immunity to HBV, the proportion was still significantly lower than that observed in the general adolescent population. This highlights the need to improve the access to basic health care and the immunization programs to HBV for street-involved youth through creative outreach programs and other multi-faceted approaches.
在加拿大，自 1998 年以来，所有省份和地区都提供了普及和公共资助的乙型肝炎免疫接种计划。本研究利用加拿大街头青年强化监测收集的数据，估计了 15-24 岁街头青年感染乙型肝炎病毒（HBV）的疫苗诱导免疫比例及其相关决定因素。疫苗诱导的免疫通过抗-HBc 阴性和抗-HBs 阳性的血液检测结果来确定。在这项研究中，纳入了 4035 名参与者，在研究期间，HBV 疫苗诱导免疫的总体比例为 51.7%，而普通青少年人群中这一比例超过 90%。1999 年至 2005 年，接受 HBV 疫苗免疫接种的街头青年比例从 34.7%增加到 64.4%。女性（优势比[OR] = 1.43，1.17-1.75）和有报告性传播感染史的人（OR = 1.30，1.03-1.63）的免疫率更高。随着年龄的增长，青年的免疫比例下降（OR = 0.78，每增加 1 年）。尽管加拿大街头青年对 HBV 的疫苗诱导免疫比例总体上有所增加，但仍明显低于普通青少年人群。这突显了需要通过创新的外展计划和其他多方面的方法，改善街头青年获得基本医疗保健和 HBV 免疫接种计划的机会。
