title: Vaccination against hepatitis A and B in persons subject to homelessness in inner Sydney: vaccine acceptance, completion rates and immunogenicity.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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 post-serological testing) essential components in achieving good vaccination completion rates.
authors: School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia. r.poulos@unsw.edu.au
authors: Roslyn G
authors: RG
authors: Poulos
authors: Mark J
authors: MJ
authors: Ferson
authors: Karen J
authors: KJ
authors: Orr
authors: Michele A
authors: MA
authors: McCarthy
authors: Susan J
authors: SJ
authors: Botham
authors: Jerome M
authors: JM
authors: Stern
authors: Adrienne
authors: A
authors: Lucey
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001315:Australia; D005260:Female; D019538:Health Care Surveys; D006506:Hepatitis A / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control*; D035922:Hepatitis A Antibodies / Q000032:analysis; D022362:Hepatitis A Vaccines / Q000008:administration & dosage / Q000276:immunology*; D006509:Hepatitis B / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control*; D006510:Hepatitis B Antibodies / Q000032:analysis; D017325:Hepatitis B Vaccines / Q000008:administration & dosage / Q000276:immunology*; D006703:Ill-Housed Persons; D006801:Humans; D017589:Immunization Programs / Q000458:organization & administration; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011204:Poverty Areas; D014611:Vaccination / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D035922:Hepatitis A Antibodies; D022362:Hepatitis A Vaccines; D006510:Hepatitis B Antibodies; D017325:Hepatitis B Vaccines