Hepatitis A outbreak among MSM in Berlin due to low vaccination coverage: Epidemiology, management, and successful interventions.
Adolescent
Adult
Aged
Berlin
/ epidemiology
Disease Outbreaks
/ prevention & control
Germany
Hepatitis A
/ epidemiology
Homosexuality, Male
Humans
Male
Middle Aged
Odds Ratio
Sexual and Gender Minorities
Vaccination
/ statistics & numerical data
Vaccination Coverage
/ statistics & numerical data
Young Adult
HAV
Hepatitis A
MSM
Outbreak
Vaccination
Vaccination coverage
Journal
International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
ISSN: 1878-3511
Titre abrégé: Int J Infect Dis
Pays: Canada
ID NLM: 9610933
Informations de publication
Date de publication:
Feb 2021
Feb 2021
Historique:
received:
11
09
2020
revised:
04
11
2020
accepted:
06
11
2020
pubmed:
19
11
2020
medline:
26
3
2021
entrez:
18
11
2020
Statut:
ppublish
Résumé
To describe the characteristics of a large hepatitis A virus (HAV) outbreak among men who have sex with men (MSM) in Berlin and to assess the impact of measures implemented. Cases of laboratory-confirmed, symptomatic HAV infection notified in Berlin, Germany between August 2016 and February 2018 were analysed using routine and enhanced surveillance data including genotyping results. Several studies involving different groups of participants were conducted to further investigate the outbreak, including surveys on knowledge and practices of HAV vaccination among physicians and vaccination coverage and determinants of vaccination status among MSM. The measures implemented were categorized by target group in a Gantt chart. To assess their impact, health insurance data on HAV vaccination uptake were analysed, comparing Berlin and other federal states. During the outbreak period, a total of 222 cases were reported (of which 91 were sequence-confirmed), with a peak in case numbers in January 2017. Physicians were aware of the existing vaccination recommendations, but vaccination coverage among 756 MSM was low, with 32.7% being completely vaccinated and 17.3% being incompletely vaccinated before 2017. HAV vaccination before 2017 was associated with being born in Germany (odds ratio 2.36) and HIV-positive (odds ratio 1.80). HAV monovalent vaccination uptake increased by 164% from 2016 to 2017 among males in Berlin, compared to 7% in other federal states. Multiple measures targeting the MSM community, physicians, and public health to increase HAV vaccination uptake were successfully implemented. To prevent future HAV outbreaks, we recommend monitoring vaccination coverage among MSM, promoting awareness of existing recommendations among physicians, and ensuring access for foreign-born and young MSM.
Identifiants
pubmed: 33207272
pii: S1201-9712(20)32327-4
doi: 10.1016/j.ijid.2020.11.133
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
146-153Informations de copyright
Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.