Variations in Hepatitis B Vaccine Series Completion by Setting Among Adults at Risk in West Virginia

Introduction: West Virginia leads the nation with the highest rate of acute hepatitis B. From 2013 to 2015, the West Virginia hepatitis B Vaccination Pilot Project distributed more than 10,000 doses of hepatitis B vaccine to at-risk adults through local health department clinics and through outreach to correctional facilities and substance use treatment centers. This study aims to determine which setting type is associated with the greatest likelihood of at-risk adults receiving all 3 or at least 2 doses of hepatitis B vaccine. Methods: Data for this retrospective cohort study were accessed, extracted, and analyzed in 2019 from Pilot Project participant forms initially completed from 2013 to 2015. Odds of receiving all 3 or at least 2 doses were calculated using bivariate, multivariable, and mixed-effects regression models. Results: Data were available for 1,201 participants. In multivariable logistic regression, participants vaccinated at substance use treatment centers (AOR=1.37, 95% CI=1.01, 1.86) and local health department family planning clinics (AOR=3.74, 95% CI=1.98, 7.06) were more likely to receive the 3-dose series versus those vaccinated at local health department sexually transmitted disease clinics. Participants vaccinated through substance use treatment centers (AOR=1.79, 95% CI=1.31, 2.44), correctional facilities (AOR=3.34, 95% CI=2.09, 5.34), and local health department family planning clinics (AOR=3.97, 95% CI=1.72, 9.16) were more likely to receive at least 2 doses. Conclusions: Hepatitis B vaccination delivered at local health department family planning clinics, substance use treatment centers, or correctional facilities may increase vaccine dose completion in West Virginia. (C) 2020 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.