Using needle exchange programs to administer vaccinations to illegal drug users is an approach that ultimately saves lives and money, according to a study published in the July issue of American Journal of Preventive Medicine and led by researchers from the Yale School of Public Health.
The researchers concluded that syringe exchange programs are an effective and economic venue to treat people who inject drugs against the deadly hepatitis B virus (HBV), an illness that is commonly passed from one user to another through a tainted needle or unprotected sexual activities.
Such vaccination programs for injectors are currently uncommon, even though the customers of syringe exchange programs are part of the population with the highest risk for hepatitis B infection and the costs associated with treating them once infected place a strain on health care systems. Similar treatment programs have been effective in prisons and other places with high-risk HBV groups.
The team enrolled 595 susceptible injectors recruited from syringe exchange locations in Chicago, Ill., and Hartford and Bridgeport, Conn., over a three-year period. Participants had to be at least 18 years old and injected illegal drugs within the past month. The research compared four vaccination strategies (with the primary difference being the timetable in which the vaccine was administered) with the results of a non-vaccination approach.
All four of the vaccination approaches resulted in cost savings when compared with the non-vaccination approach. In particular, an accelerated vaccination program (where the first dose was delivered at the screening visit and the third and final dose of vaccine was administered two months after the first) was the most effective in terms of infections prevented and money saved—approximately a half-million dollars over the lifetimes of the 595 study participants.
The study used a vaccine that cost $10 per dose (as would be the case if obtained by state health departments from the CDC). Typically the retail cost would be closer to $55 per dose. The higher-priced doses would decrease the magnitude of savings, but did not change the overall results of the four vaccination approaches.
The research team consisted of Yiqing Hu, a doctoral student at Yale, Robert Heimer, the project’s principal investigator, Lauretta E. Grau, an associate research scientist, and researchers from four other institutions. The researchers said the findings can be extended to any program or service that comes into repeated contact with populations at risk of HBV infection. In the case of drug users, this would include drug treatment, especially long-term programs with high rates of retention such as methadone maintenance, and prisons.