Identifying Missed Opportunities for Routine Vaccination among People Who Use Drugs

Paula M. Frew, Jay T. Schamel, Laura A. Randall, Adrian R. King, Ian W. Holloway, Katherine Burris, Anne C. Spaulding and Project Team Hbou
Additional contact information
Paula M. Frew: UNLV School of Public Health, UNLV School of Medicine, and UNLV Population Health & Health Equity Initiative, University of Nevada, Las Vegas, NV 89154, USA
Jay T. Schamel: UNLV School of Public Health, UNLV School of Medicine, and UNLV Population Health & Health Equity Initiative, University of Nevada, Las Vegas, NV 89154, USA
Laura A. Randall: UNLV School of Public Health, UNLV School of Medicine, and UNLV Population Health & Health Equity Initiative, University of Nevada, Las Vegas, NV 89154, USA
Adrian R. King: UNLV School of Public Health, UNLV School of Medicine, and UNLV Population Health & Health Equity Initiative, University of Nevada, Las Vegas, NV 89154, USA
Ian W. Holloway: Department of Social Welfare, UCLA Luskin School of Public Affairs, Los Angeles, CA 90095, USA
Katherine Burris: UNLV School of Public Health, UNLV School of Medicine, and UNLV Population Health & Health Equity Initiative, University of Nevada, Las Vegas, NV 89154, USA
Anne C. Spaulding: Department of Epidemiology, Emory University, Atlanta, GA 30322, USA
Project Team Hbou: Group email: hbou@unlv.edu . All members are cited in the Acknowledgement section.

IJERPH, 2021, vol. 18, issue 4, 1-17

Abstract: 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, p = 0.02). HBV receipt was higher among participants who were not intravenous drug users (56.1% vs. 46.0%, p = 0.03). Additionally, income >$20k predicted higher rates of MMR receipt (67.0% vs. 56.5%, p = 0.009), as did stable housing (62.8% vs. 54.3%, p = 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.

Keywords: adult vaccination; vaccine missed opportunities; immunization; vaccine uptake; vaccine coverage; substance use; opioid crisis; social determinants; hidden populations; health equity (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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