Success of Venue-Based Adult Hepatitis B Vaccination Varies by Type of Public Venue: Cdc's Adult Hepatitis B Vaccination Initiative

Background: Hepatitis B incidence in the United States is highest among adults ages 30–45 years. Since September 2007, CDC has provided federally purchased monovalent hepatitis B and combination hepatitis A/B vaccine to 51 state and local health departments. These health departments enrolled 1893 venues within their jurisdictions as distribution points for vaccine administration to high-risk adults. Venues include STD clinics, HIV counseling and testing sites, jails, prisons, syringe exchange programs, substance abuse treatment centers, primary care clinics, and local health departments.

Objectives: To evaluate CDC’s implementation of the Venue-Based Adult Hepatitis B Vaccination Initiative.

Methods: Venues reported number of doses of each vaccine ordered and administered by quarter on a standardized Excel® spreadsheet. We examined data from November 1, 2007 to October 31, 2008.

Results: Of 1893 venues enrolled, 1065 (56.3%) reported administering vaccine. Of the 475,416 vaccine doses ordered, 246,211 (51.8%) were administered during the year. Certain venue types were able to administer more vaccine and use a greater proportion of the vaccine they ordered, in particular local health departments (89,939, 66%), STD clinics (73,094, 62%), and jails (27,056, 55%). Other venue types that provided less vaccine also administered lower proportions of the vaccine they ordered including syringe exchange programs (626, 23%) and primary care clinics (8,232, 28%).

Conclusions: With provision of vaccine but no funding for infrastructure, hepatitis B – containing vaccine was provided to adults at high-risk for HBV acquisition through venues selected by state and local health departments. The positive correlation between the amount of vaccine administered and the proportion of vaccine administered may reflect the fact that venues serving larger populations and those accustomed to vaccinating were more able to rapidly implement this new immunization program. Venues with the highest levels of vaccine administration may be uniquely situated to provide other critical vaccines to high-risk adult populations.