Uptake of COVID-19 vaccination among people who inject drugs.

BACKGROUND: People who inject drugs (PWID) may be at elevated risk of adverse outcomes from SARS-CoV-2 infection; however, data on COVID-19 vaccine uptake among PWID are scarce. This study aimed to determine COVID-19 vaccine uptake among PWID, identify factors associated with sub-optimal uptake, and compare uptake to the general population. METHODS: The Australian Needle Syringe Program Survey is an annual sentinel surveillance project, comprising a self-completed questionnaire and provision of a dried blood sample for HIV and HCV testing. In 2021, respondents provided information on their COVID-19 vaccination status. Multivariate logistic regression models identified correlates of vaccine uptake. RESULTS: Among 1166 respondents, 49% had been vaccinated and in most states and territories, vaccine uptake was significantly lower than among the general population. Independent predictors of vaccine uptake were longer duration of vaccine eligibility (AOR 3.42, 95% CI 2.65, 4.41); prior SARS-CoV-2 diagnostic testing (AOR 2.90, 95% CI 2.22, 3.79); injection of opioids (AOR 1.91, 95% CI 1.20, 3.05); and current opioid agonist therapy (AOR 1.70, 95% CI 1.23, 2.33). Women (AOR 0.70, 95% CI 0.54, 0.92) and those who reported daily or more frequent injection (AOR 0.75, 95% CI 0.57, 1.00) were significantly less likely to be vaccinated. CONCLUSIONS: In most Australian states and territories, uptake of COVID-19 vaccine among PWID lagged uptake among the general population. Increased efforts are required to ensure PWID have equitable access to vaccination. Vaccination programmes within harm reduction services and via outreach, coupled with increased support for peers to act as vaccine champions, are likely to reduce barriers and improve COVID-19 vaccine uptake in this population.

Threat or opportunity? Secondary exchange in a setting with widespread availability of needles.

Where authorized access to needles and syringes from exchanges and pharmacies is limited, secondary exchange (SE) can provide an important source of sterile injecting equipment. Interventions can be developed to use SE to facilitate needle and syringe exchange programs to reach a wider population of drug injectors. Yet in a context such as Western Australia, where needles and syringes are available to drug injectors from many authorized sources, the added benefit of SE is unknown. This review of data and literature conducted in October 2003 shows potential benefits but also concerns about undermining vulnerable public and political support for authorized needle provision schemes that has been nurtured and supported over a number of years.