Researchers from Yale University used needle exchange programs in Hartford, Bridgeport and Chicago to test the impact and benefit of a Hepatitis B vaccination program on intravenous drug users.

Yale University Researcher Lauretta Grau said that given the “chaotic nature of an injection drug users life we wanted to see if we gave them the first shot, if they would return for the second and third.” The study released Friday compared an accelerated dose, which consisted of three shots over two months to the standard dose which includes three shots over six months.

Of the 595 people who received the first does, 460 returned after one month for the second dose. Of the 324 given the accelerated dose, 206 returned at month two for the third dose. Of the 271 given the standard does, 141 returned in month six for the third dose. The return rate for those who received the accelerated dose was only slightly higher than those who received the standard dose.

Grau said returned rates were lower for people who said their primary language was Spanish, but it’s unclear why. She said further study on this topic needs to be done. The good news is knowledge of Hepatitis B improved over the course of the study, she said.

The bottomline is the needle exchange sites are a good venue to administer the vaccine because “the people who work on these vans are their friends,” Grau said. 

Yale Researcher Yiqing Hu said if the vaccination prevents one acute infection it would save an estimated $8,061.

Merrill Singer, director of research at the Hispanic Health Council, said when funding for public health is cut the results are devastating. He said a study in the American Journal of Public Health this month estimated that New York City’s $10 billion budget cut in 1975 cost it $50 billion in 2004.

The American Journal of Public Health article by Nicholas Freudenberg, DrPH, Marianne Fahs, PhD, Sandro Galea, MD, DrPH, and Andrew Greenberg, MS, concluded, “Budget and policy decisions designed to alleviate this fiscal crisis contributed to the subsequent epidemics of tuberculosis, human immunodeficiency virus (HIV) infection, and homicide in New York City. Because these conditions share underlying social determinants, we consider them a syndemic, i.e., all 3 combined to create an excess disease burden on the population. Cuts in services; the dismantling of health, public safety, and social service infrastructures; and the deterioration of living conditions for vulnerable populations contributed to the amplification of these health conditions over 2 decades. We estimate that the costs incurred in controlling these epidemics exceeded $50 billion (in 2004 dollars); in contrast, the overall budgetary saving during the fiscal crisis was $10 billion.”

He said based on this study the recent cuts to the federal Ryan White funding could lead to future increases in HIV and AIDS cases.

Click here for more information from the CDC on Hepatitis B.