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Hepatitis B vaccination for sex workers: do outreach programmes perform better?
  1. R Mak1,
  2. A Traen2,
  3. M Claeyssens2,
  4. L Van Renterghem3,
  5. G Leroux-Roels4,
  6. P Van Damme5
  1. 1Department of Public Health, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium
  2. 2PASOP VZW, Brabantdam 100B, 9000 Ghent, Belgium
  3. 3Laboratory of Bacteriology and Virology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium
  4. 4Centre for Vaccinology, Ghent University and Hospital, De Pintelaan 185, 9000 Ghent, Belgium
  5. 5Centre for the Evaluation of Vaccination, WHO Collaborating Centre, Department Epidemiology and Social Medicine, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
  1. Correspondence to:
 Rudolf Mak, MD, Department of Public Health, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium;


Objectives: To assess to what extent hepatitis B vaccination of sex workers in Ghent, Belgium, is successful within the context of the existing health services and to compare this with alternative approaches such as outreach programmes; to compare two hepatitis B vaccination schemes in the outreach programme for sex workers.

Methods: Testing all first contacts (n = 1096) in the outreach programme for hepatitis B virus (HBV) markers assessed success of hepatitis B vaccination in routine services. The performance of the outreach service was measured by counting the number of sex workers who started hepatitis B vaccination in the programme. The hepatitis B vaccination schemes were assessed by analysing the number of people completing the vaccination.

Results: Naturally acquired HBV was found in 11.9% of 1096 sex workers (0.6% HBsAg), and 7% were vaccinated in existing services. In contrast, hepatitis B vaccination using outreach methodology was able to achieve higher vaccination rates: among non-immune sex workers 82.8% received the first dose of vaccine, and 71.5% the second. If given 1 month later, 67.9% received the third dose, in contrast with 47.9%, when given 6 months later.

Conclusions: Existing services are not successful in vaccinating sex workers for HBV, in contrast with specifically targeted outreach services. Shorter intervals between vaccine doses gave better compliance.

  • hepatitis B
  • vaccination
  • sex workers
  • outreach programmes
  • Belgium

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