UNLV School of Public Health, UNLV School of Medicine, and UNLV Population Health & Health Equity Initiative, University of Nevada, Las Vegas, NV 89154, USA.
Department of Social Welfare, UCLA Luskin School of Public Affairs, Los Angeles, CA 90095, USA.
Int J Environ Res Public Health. 2021 Feb 4;18(4):1447. doi: 10.3390/ijerph18041447.
In the US, adult immunization coverage remains low, especially among vulnerable populations, as recent hepatitis A outbreaks have demonstrated. We studied the vaccination history variation among the US adults who use drugs by implementing a community-engaged research survey to identify reported immunization coverage, missed opportunities (MO), and places where immunizations might be delivered. Our analysis of a sample of 1127 participants recruited at community syringe exchanges in three cities identified higher overall vaccination receipt in Los Angeles compared to Atlanta or Las Vegas (e.g., HAV receipt 52.2% LA, 42.1% LV, 41.4% Atlanta). Overall, fewer participants reported having received HAV (45.9%), HBV (47.5%), or influenza (47.6%) vaccines than MMR (57.1%) or Td/Tdap (61.1%). Across sites, HAV receipt was higher for participants incarcerated ≥ 5 years (54.2% vs. 43.6% for those incarcerated < 5 years, 49.4% no incarceration history, = 0.02). HBV receipt was higher among participants who were not intravenous drug users (56.1% vs. 46.0%, = 0.03). Additionally, income >$20k predicted higher rates of MMR receipt (67.0% vs. 56.5%, = 0.009), as did stable housing (62.8% vs. 54.3%, = 0.01). To address the need to expand vaccine coverage among vulnerable adults, delivering vaccine at sites where persons who use drugs access services, or in correctional facilities, may be warranted.
在美国，成人免疫接种率仍然较低，尤其是在弱势群体中，最近的甲型肝炎疫情爆发就证明了这一点。我们通过实施一项社区参与式研究调查，研究了使用毒品的美国成年人的疫苗接种史变化，以确定报告的免疫接种覆盖率、错失机会（MO）以及可以接种疫苗的地方。我们对在三个城市的社区注射器交换处招募的 1127 名参与者的样本进行了分析，发现洛杉矶的整体疫苗接种率高于亚特兰大和拉斯维加斯（例如，HAV 接种率为 52.2%，LV 为 42.1%，亚特兰大为 41.4%）。总体而言，报告接种 HAV（45.9%）、HBV（47.5%）或流感（47.6%）疫苗的参与者少于 MMR（57.1%）或 Td/Tdap（61.1%）。在所有地点，入狱≥5 年的参与者 HAV 接种率更高（54.2%比入狱<5 年的参与者高 43.6%，无入狱史的参与者为 49.4%， = 0.02）。非静脉吸毒者的 HBV 接种率更高（56.1%比 46.0%， = 0.03）。此外，收入>20k 预测 MMR 接种率更高（67.0%比 56.5%， = 0.009），稳定的住房也是如此（62.8%比 54.3%， = 0.01）。为了扩大弱势群体中脆弱成年人的疫苗接种覆盖率，在吸毒者获取服务的场所或在惩教设施中提供疫苗可能是必要的。
