Interventions to Increase Completion of Hepatitis B Vaccination in People who Inject Drugs: A Systematic Review and Meta-analysis

Increases in opioid misuse and injection drug use have resulted in a rise in acute cases of hepatitis B. We conducted a systematic review and meta-analysis of randomized studies to determine the effect (pooled odds ratio) of interventions to increase hepatitis B vaccination completion in people who inject drugs (PWID). Odds ratios from the included studies were combined to create a pooled odds ratio (OR) using the Inverse Heterogeneity Model. Eleven studies met the eligibility criterion of having a randomized intervention to increase hepatitis B virus vaccination completion among PWID. The odds of vaccine completion in the intervention group were greater than in the control/comparison group (pooled OR, 2.53; 95% confidence interval [CI], 1.07-5.99). Subgroup analysis indicated that financial incentives were most effective (OR, 7.01; 95% CI, 2.88-17.06), followed by accelerated vaccine schedules (OR, 1.90; 95% CI, 1.14-3.14). Interventions using financial incentives and accelerated vaccine schedules are moderately effective at increasing hepatitis B vaccination completion in PWID.