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Abstract Details
Impact of a Vaccine Intervention on County-Level Rates of Acute Hepatitis B in West Virginia, 2011-2018
Prev Med. 2020 Aug;137:106121. doi: 10.1016/j.ypmed.2020.106121. Epub 2020 May 8.
Stacy R Tressler1, Gordon S Smith2, Brian M Hendricks2
Author information
1Department of Epidemiology, West Virginia University, Morgantown, WV, USA. Electronic address: stacy.r.tressler@gmail.com.
2Department of Epidemiology, West Virginia University, Morgantown, WV, USA.
Abstract
The rate of acute hepatitis B in West Virginia (WV) has been increasing since 2006. To reduce new infections, WV implemented a vaccine intervention (WV Pilot Project), which provided over 10,000 doses of hepatitis B vaccine to at-risk adults in 18 counties. The objectives of this study were to describe yearly changes in acute hepatitis B incidence and assess county-level impact of the WV Pilot Project using geospatial methods. County rates of acute hepatitis B and vaccine doses per 100,000 population were visualized biannually from 2011 to 2018. Local indicators of spatial autocorrelation were used to detect county-level clustering. Significant differences in the median rate of acute hepatitis B pre and post intervention in counties receiving vaccine were evaluated using Wilcoxon signed-rank test and bootstrapping. A Bland-Altman graph visualized significant differences in county-level rates of acute hepatitis B before and after the WV Pilot Project compared to the statewide estimate. Analyses identified significant geographic clustering of acute hepatitis B in southern WV across all four time-periods. Nine of the 18 (50%) counties receiving vaccine had significant declines in acute hepatitis B incidence compared to the statewide mean difference estimate. Findings suggest that increased dissemination of hepatitis B vaccine through local health departments and existing harm reduction services can reduce the incidence of acute hepatitis B in states such as WV, which have been disproportionately affected by substance misuse.