Vaccine immunogenicity in injecting drug users: a systematic review.
Injection drug use is a prevalent global phenomenon; one not bound by a country's level of development or geographical location. Injection drug users (IDUs) are at high risk for a variety of parenterally acquired and transmitted infections. Licensed vaccines are available for some of these infectious diseases, such as tetanus, influenza, and hepatitis A and B viruses; however, there have been conflicting reports as to their immunogenicity in IDUs. We summarise the lessons learned from studies evaluating the immunogenicity of vaccination strategies in IDUs. A common theme across these diseases is that although there is a tendency towards decreased antibody responses after immunisation, there is no conclusive evidence linking these observations to a decrease in clinical protection from infection. There is a clear need for definitive studies of vaccination strategies in IDUs; however, a synthesis of the available published evidence suggests that immunisation does result in effective clinical protection from disease in this population. The inclusion of IDUs as a high-risk study population in future trials evaluating HIV and hepatitis C virus vaccines will help to assess the immunogenicity of candidate vaccines against parenteral exposure, and also to evaluate the efficacy of candidates as promising antigens become available.
Baral
Stefan
S
Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD 21205, USA. sbaral@jhsph.edu
Sherman
Susan G
SG
Millson
Peggy
P
Beyrer
Chris
C
D000293:Adolescent; D000328:Adult; D000818:Animals; D000907:Antibodies, Bacterial / Q000097:blood*; D000914:Antibodies, Viral / Q000097:blood*; D006506:Hepatitis A / Q000276:immunology / Q000517:prevention & control; D006509:Hepatitis B / Q000276:immunology / Q000517:prevention & control; D006801:Humans; D007115:Immunization Schedule; D007251:Influenza, Human / Q000276:immunology / Q000517:prevention & control; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D015819:Substance Abuse, Intravenous / Q000150:complications*; D013742:Tetanus / Q000276:immunology / Q000517:prevention & control; D013745:Tetanus Toxoid / Q000008:administration & dosage / Q000276:immunology*; D014611:Vaccination / Q000379:methods / Q000706:statistics & numerical data; D014765:Viral Vaccines / Q000008:administration & dosage / Q000276:immunology*
D000907:Antibodies, Bacterial; D000914:Antibodies, Viral; D013745:Tetanus Toxoid; D014765:Viral Vaccines