COVID-19 Vaccination at a Swedish Needle Exchange Program – A Means of Fighting The Pandemic

Author: Sara Alsterberg Eva Öfverström Pernilla Isendahl Susanne Quick Marianne Alanko Blomé

Theme: Models of Care Year: 2022

Sweden was affected by the SARS-CoV-2 pandemic with regional variations. In Skane region the
highest rates of transmission so far were observed in Dec 2020 – Jan 2021. Vaccination against
Covid-19 was orderly implemented in the end of December 2020, starting with the elderly. In May
2021 persons with expected difficulties to follow national guidelines were offered vaccination.
Description of model of care/intervention:
The Malmö Needle Exchange Program (MNEP) offers vaccination against hepatitis B since 1994 and
hepatitis A since 1999. In 2021 the MNEP had 557 participants, 70 % male, mean age 38,5 years.
From mid-May 2021 all participants were offered vaccination with Moderna COVID-19 (mRNA-1273),
given according to the schedule as per manufacturer specification, in 2 doses (100 µg, 0.5 ml each)
intramuscularly into the deltoid muscle, 4 weeks apart.
During the first month 112 first doses were given. A further 13 first doses were given later,
corresponding to 125 first doses in total. Thus 20 % of the annual visitors were vaccinated in one
month. Subsequently 107 second doses were given. When a third dose was recommended in
national guidelines 52 third doses were given from Dec 2021 to March 2022. In total, 284 vaccine
doses were given. Approximately 85 % of those having received a first dose came back for the
second dose, 49 % of them received a third dose. No adverse reactions were observed. Reasons for
not being vaccinated on site were medical/allergic reasons, participants’ objections and having
received vaccination elsewhere.
Conclusion and next steps:
Persons with ongoing injection drug use may be hard to reach by Covid-19 vaccination programs.
They may also be exposed to the virus without means to provide care for themselves or preventing
forward transmission due to unstable housing. A needle exchange program can be used to provide
Disclosure of Interest Statement:

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