Hepatitis B vaccination practices in state and federal prisons

Abstract

Objective: Incarcerated populations are a group at high risk for hepatitis B. About 30% of people experiencing acute hepatitis B virus infection (HBV) have a history of incarceration. Offering routine HBV vaccinations to incarcerated individuals could have a significant effect on public health. The objective of this study is to identify current vaccine practices and the perceived feasibility of routine vaccinations for hepatitis B within correctional settings.

Method: The authors surveyed the medical directors of state correctional facilities in all 50 states and the federal prison system regarding current HBV vaccine practices. Surveys were faxed or mailed between July 1 and September 1, 2000.

Results: Thirty-five states and the federal system responded (response rate = 70.6%). These systems account for 77% of all inmates in federal or state prisons and jails. Two states give hepatitis B vaccine routinely, nine states offer no hepatitis B vaccine, and 26 states and the Federal Bureau of Prisons offer hepatitis vaccine to some inmates. Most states do not spend enough money to vaccinate even those prisoners at highest risk. Under the Vaccine for Children program, 19,520 youths could receive vaccine immediately. According to the respondents, if vaccine were available at no-cost, 25 states and the Federal Bureau of Prisons would routinely offer vaccination to all inmates.

Conclusions: Most correctional systems do not routinely offer vaccine to their incarcerated populations, but would if funds were available. There exists now a unique public health opportunity to prevent a significant proportion of new hepatitis B infections.