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首页> 外文学位 >Hepatitis B vaccination at syringe exchange programs in three US cities: Vaccine efficacy for the standard versus accelerated dosing schedules and determinants of completing the vaccination series among active injection drug users.
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Hepatitis B vaccination at syringe exchange programs in three US cities: Vaccine efficacy for the standard versus accelerated dosing schedules and determinants of completing the vaccination series among active injection drug users.

机译：在美国三个城市的注射器交换计划中进行的乙肝疫苗接种：标准疫苗接种效率与加速给药时间表的比较，以及活跃注射吸毒者完成疫苗接种系列的决定因素。

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摘要

Hepatitis B vaccination (HBV) rates are low among injection drug users (IDU) despite the availability of a safe and effective vaccine. Shortening the vaccine schedule and providing the vaccine series at SEPs with modest financial compensation are proven strategies to improve HBV vaccination uptake among IDUs. The Hepatitis Vaccine Study (HVS) was a randomized trial comparing the efficacy of the standard HBV vaccination schedule (0, 1, and 6 months) to an accelerated schedule (0, 1, and 2 months). Loss to follow-up was high during the study, and a post hoc analysis was conducted to evaluate factors distinguishing completers from non-completers.;With respect to vaccination efficacy, neither the standard nor the accelerated dosing schedule proved superior based on the present evaluation. The post hoc analysis revealed the following covariates to be associated with completion of the three-dose vaccine series: accelerated vaccine schedule (aOR 1.92, 95%CI 1.34, 2.58, p=0.001), older age (aOR 1.05, 95%CI 1.03, 1.07, p=0.001), and higher self-rated health score (aOR 1.26, 95%CI 1.05, 1.5, p=.02). Completion was less likely for those getting syringes from SEP customers than for SEP customers (OR 0.33, 95%CI 0.19, 0.58, p=0.001). However, improvements in completion among the accelerated group were mitigated by lower rates of reaching the threshold for immunological protection.;These findings suggest that SEPs offering hepatitis vaccination should consider minimizing the time between first and last visits; one strategy is to offer the first dose at the screening visit. Specific attention is required to encourage vaccine completion among younger and/or less healthy participants and among SEP non-customers. Drawing on peer networks to encourage completion among those receiving syringes from SEP participants may help to improve completion rates in this population. These recommendations may also be applicable to other health interventions offered at SEPs.
机译：尽管有安全有效的疫苗，但注射吸毒者（IDU）的乙肝疫苗接种率很低。事实证明，缩短疫苗接种时间表并在SEPs上为疫苗系列提供适度的经济补偿是提高IDU中HBV疫苗接种率的有效策略。肝炎疫苗研究（HVS）是一项随机试验，将标准HBV疫苗接种时间表（0、1、6个月）与加速时间表（0、1、2个月）的疗效进行了比较。在研究过程中失访率很高，并且进行了事后分析以评估将完成者与未完成者区分开的因素;关于疫苗接种的有效性，根据目前的评估，标准和加速给药方案均未证明是优越的。事后分析显示，以下协变量与三剂疫苗系列的完成相关：加速疫苗接种时间表（aOR 1.92，95％CI 1.34，2.58，p = <0.001），年龄较大（aOR 1.05，95％CI 1.03、1.07，p = <0.001）和更高的自我评估健康评分（aOR 1.26、95％CI 1.05、1.5，p = .02）。与SEP客户相比，从SEP客户获得注射器的完成可能性较小（OR 0.33、95％CI 0.19、0.58，p = <0.001）。然而，加速组中完成率的提高因降低了达到免疫保护阈值的比率而降低了。这些发现表明，提供肝炎疫苗接种的SEP应考虑尽量减少首次就诊和最后一次就诊之间的时间。一种策略是在筛选访视时提供第一剂。需要特别注意，以鼓励年轻和/或较不健康的参与者以及SEP非客户中的疫苗接种完成。利用对等网络来鼓励那些接受SEP参与者注射的人中的完成率，可能有助于提高该人群的完成率。这些建议也可能适用于SEP提供的其他健康干预措施。

著录项

  • 作者

    Bowman, Sarah E.;

  • 作者单位

    Yale University.;

  • 授予单位 Yale University.;
  • 学科 Health Sciences Public Health.
  • 学位 M.P.H.
  • 年度 2010
  • 页码 52 p.
  • 总页数 52
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
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