Hepatitis B

There are longstanding recommendations to vaccinate adults at increased risk for hepatitis B virus (HBV) infection. However, widespread nationwide programs do not exist that integrate hepatitis B immunization into programs that serve high-risk adults. Since 1996, 84 out of 236 patients diagnosed with acute hepatitis B reported prior treatment for a sexually transmitted disease (STD), one reason why STD clinics are an excellent access point for giving hepatitis B vaccinations.

Over the past decade studies have shown, when cost is not a barrier, a large percentage of persons who use STD clinic services will begin their hepatitis B vaccine series. While completion of the 3-dose vaccine series is best, protective levels of antibody develop in 32%-56% of adults after 1 dose and in more than 70% of adults after 2 doses. The duration of protection against hepatitis B with less than 3 doses of hepatitis B vaccine is not known; however, completion of the vaccine series should not preclude initiating vaccination in high-risk adults.

Overcoming Barriers
Recent surveys indicate that vaccine purchase is the limiting factor for development and implementation of hepatitis B immunization programs for high-risk adults. While resources such as the Vaccines for Children Program exist to provide vaccine for persons aged less than 19 years, similar programs focused on adult vaccination are scarce. Despite such financial barriers, initiating hepatitis B vaccination of high-risk adults is an attainable goal for many STD and HIV/AIDS clinics. The resources below provide guidance for planning and implementing hepatitis B vaccination programs within existing STD and HIV/AIDS programs and clinics.

Hepatitis B Immunization in an STD Clinic:
Lessons Learned in San Diego County - A Practical Guide
This manual is designed to help STD clinics incorporate hepatitis B immunizations into their existing counseling and treatment programs. It contains information on how to get buy-in from key stakeholders, how and what to train clinic staff, patient education, and implementation. San Diego County's experience is provided as an example.
Read the accessible PDF version of the manual.

(2.96 MB)

Starting Up: First Steps Toward the Integration of Viral Hepatitis into HIV/AIDS/STD Programs
This National Association of State and Territorial AIDS Directors (NASTAD) resource guide was created to develop a comprehensive model for integrating viral hepatitis prevention into HIV/AIDS programs.

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