Vaccination against hepatitis A and B in persons subject to homelessness in inner Sydney: vaccine acceptance, completion rates and immunogenicity

Objectives: To determine acceptance, completion rates and immunogenicity of the standard vaccination schedule for hepatitis A (HAV) and B (HBV) in persons subject to homelessness Methods: A convenience sample of clients (n=201) attending a medical clinic for homeless and disadvantaged persons in Sydney was enrolled Serological screening for HAV and HBV was undertaken An appropriate vaccination program was instituted Post-vaccination serology determined serological response Results: Although many clients had serological evidence of past infection, at least 138 (69%) clients had the potential to benefit from vaccination For hepatitis A and B vaccinations, completion rates were 73% (73 of 100 clients) and 75% (69 of 92 clients), respectively, after vaccination, protective antibody was found in 98 2% (56 of 57) and 72% (36 of 50) of clients. respectively Conclusion: A successful vaccination program can be mounted with a vulnerable population We consider a clinic with a well-established history of acceptance and utilisation by the target group, a low staff turnover and regular clientele, inclusion of vaccination as part of routine client care, and counselling (part of pre- and postserological testing) essential components in achieving good vaccination completion rates