Vaccination of High Risk Inmates in Los Angeles County Men's Central Jail with Accelerated Schedule Hepatitis A/B Vaccine

Background:
Guidelines recommend hepatitis A and B vaccination for incarcerated persons and men who have sex with men (MSM).

Objective:
To describe the implementation of a hepatitis A and B vaccination demonstration project in a unit housing 500 MSM and transgendered persons in a Los Angeles County Jail.

Method:
In August 2007, the STD Program, in collaboration with the Sheriff's Department and Immunization Program, implemented a one year hepatitis vaccination program using the newly FDA-approved accelerated (4 dose) schedule of combination A/B vaccine (0, 7 days, 21-28 days and 12 months). Data were collected from immunization and STD screening medical records. Inmates were entered onto LINK, a web-based immunization registry.

Result:
From 8/1/2007 to 10/12/2007, 607 doses of Hepatitis A/B combination vaccine were given to 277 inmates. So far 125 have received 3 doses, 80 had 2 doses and 72 inmates had 1 dose. Two inmates received one dose of Hepatitis A vaccine. 30% of inmates (83/227) were unable to continue the series in jail either because they were released (56) or sent to prison (27). 4 inmates declined further vaccination due to side effects. Of the inmates vaccinated: 249 (90%) were male and 28 (10%) were transgender; 53 (19%) had sex for drugs or money, 59 (21%) injected drugs and 67 (24%) reported being HIV positive. Only one inmate opted out of the registry.

Conclusion:
Providing vaccination to inmates at high risk of hepatitis A and B is feasible and the accelerated schedule enables the majority of vaccines to receive 2 or more doses during their short jail stay.

Implications:
Accelerated schedule hepatitis A/B vaccine can be used in the jail setting.