Key result
Public health measures targeting the MSM community and physicians increased HAV monovalent vaccination uptake by 164% among males in Berlin, compared to 7% in other federal states.
Why the study?
The study was conducted to describe the characteristics of a large hepatitis A virus outbreak among men who have sex with men in Berlin and to assess the impact of implemented measures.
Observational (n=756)
Absolute Event Rate: 164% vs 7%
Targeted public health interventions successfully increased HAV vaccination uptake among MSM during an outbreak in Berlin.
Targeted interventions boosted HAV vaccination uptake among Berlin MSM; leaves open optimal strategies for sustained outbreak prevention in low-coverage groups.
OBJECTIVES: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
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Zimmermann et al. (2020) conducted an observational in Hepatitis A (n=756). Public health measures to increase HAV vaccination vs. Other federal states was evaluated on Increase in HAV monovalent vaccination uptake from 2016 to 2017 among males. Public health measures targeting the MSM community and physicians increased HAV monovalent vaccination uptake by 164% among males in Berlin, compared to 7% in other federal states.
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