People Who Use or Inject Drugs and Viral Hepatitis

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People who use or inject drugs should be vaccinated against hepatitis A, and people who inject drugs should be vaccinated against hepatitis B. People who inject drugs should be tested for hepatitis B and hepatitis C.

CDC and the Advisory Committee on Immunization Practices (ACIP) recommend that people who use drugs (PWUD) and people who inject drugs (PWID) get vaccinated against hepatitis A and that PWID get vaccinated against hepatitis B. Because of higher rates of infection among this population, CDC also recommends testing anyone who has injected drugs for hepatitis B. CDC now recommends one-time hepatitis C testing of all adults (people 18 years and older). CDC continues to recommend that people with risk factors, including people who inject drugs, be tested regularly.

People Who Use or Inject Drugs and Hepatitis A
Current widespread outbreaks of hepatitis A are occurring across the country. Such outbreaks are believed to occur through both percutaneous and fecal-oral routes. Severe complications, high rates of hospitalization, and even deaths have occurred nationwide as a result of these outbreaks. While hepatitis A can affect anyone, in these outbreaks certain groups are at greater risk of being infected, including people who use or inject drugs. To help stop the outbreaks, CDC recommends the hepatitis A vaccine for PWUD and PWID.

People Who Inject Drugs and Hepatitis B and Hepatitis C
Both hepatitis B and hepatitis C are bloodborne diseases. PWID are at risk for hepatitis B virus (HBV) and hepatitis C virus (HCV) infection through the sharing of needles and any equipment used to prepare and inject drugs. In recent years, an emerging HCV epidemic has been occurring among young PWID, particularly in rural and suburban settings, underscoring the need for routine hepatitis C testing for people who continue to engage in high-risk behaviors.

Scientific Guidelines and Recommendations

Prevention of Hepatitis A Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices, 2020
MMWR 2020;69(5);1–38

CDC Recommendations for Hepatitis C Screening Among Adults — United States, 2020
MMWR 2020; 69(2);1–17

Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices
MMWR 2018;67(No. RR-1):1–31

Integrated Prevention Services for HIV Infection, Viral Hepatitis, Sexually Transmitted Diseases, and Tuberculosis for Persons Who Use Drugs Illicitly: Summary Guidance from CDC and the U.S. Department of Health and Human Services
MMWR 2012;61(RR-5);1-40

Recommendations for Identification and Public Health Management of Persons with Chronic Hepatitis B Virus Infection
MMWR 2008;57(RR-8)

Resources

CDC

Federal

Other

Communication Resources for Health Care Providers

Posters, Digital Tools and Social Media
Download these posters and digital images to print and share via websites, email signatures, social media, digital advertising, or other online platforms to encourage health professionals and service providers to vaccinate people who use and inject drugs for hepatitis A and hepatitis B.

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“Don’t wait to vaccinate. People who inject drugs are at higher risk for hepatitis A and B. Protection is Prevention.”

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“No stigma. Just safekeeping. When providing services for patients who inject drugs, provide them support and inform them that hepatitis A and hepatitis B vaccination can protect them for life.”

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“Be someone they can trust. Other people may have let them down. Take away stigma and make sure people who inject drugs understand their risk for hepatitis A and hepatitis B and the importance of getting vaccinated to be protected for life.”

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“No stigma. Just safekeeping. When providing services for patients who inject drugs, provide them support and inform them that hepatitis A and hepatitis B vaccination can protect them for life.”

Resources for People Who Use or Inject Drugs

Hepatitis A Outbreak

Educational materials for people who use and inject drugs are available to address the hepatitis A outbreaks occurring across the U.S. at the state and local levels. Most materials include an area where local information on available vaccination services can be inserted.

Hepatitis A and Hepatitis B Vaccination

Vaccine Card
Download this wallet sized vaccine card pdf icon[PDF – 2 pages] to help people who use and inject drugs and service providers track hepatitis A and hepatitis B vaccine dosage over time.

Posters, Digital Tools and Social Media
Download these posters, which you can localize, and digital images to share via social media and other digital or online platforms to encourage people who use and inject drugs to get vaccinated for hepatitis A and hepatitis B. All materials are available in versions with and without the CDC logo.

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“You deserve to be healthy. If you’ve ever used or injected drugs, make sure your liver is protected from hepatitis A and hepatitis B. Ask your healthcare provider for safe, effective vaccines today.”

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“You’re a survivor. Ask your healthcare provider to protect your liver against hepatitis A and hepatitis B with safe, effective vaccines.”

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“You are a survivor. You deserve to be healthy. Safe, effective vaccines can protect you from hepatitis A and hepatitis B. Your life is worth it.”

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“You are a survivor. Your story doesn’t end here. People who inject drugs are at risk for hepatitis A and hepatitis B, but you can get safe, effective vaccines now that can protect your liver. Ask a healthcare provider or local syringe services program for these shots today.”

Hepatitis C Resources