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Hepatitis A vaccine uptake among men who have sex with men from a time-limited vaccination programme in Melbourne in 2018
  1. Sam Burrell1,2,
  2. Lenka A Vodstrcil1,2,
  3. Christopher K Fairley1,2,
  4. Alex Kilner1,3,
  5. Catriona S Bradshaw1,2,
  6. Marcus Y Chen1,2,
  7. Eric P F Chow1,2
  1. 1 Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia
  2. 2 Central Clinical School, Monash University, Melbourne, Victoria, Australia
  3. 3 Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia
  1. Correspondence to Associate Professor Eric P F Chow, Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria 3053, Australia; eric.chow{at}monash.edu

Abstract

Objectives In 2017, an outbreak of hepatitis A among gay, bisexual and other men who have sex with men (MSM) was reported in Victoria, Australia. In 2018, the Victorian government implemented a free hepatitis A vaccination programme targeting all Victorian MSM. This study aimed to determine hepatitis A vaccine uptake among MSM in a sexual health clinic in Melbourne.

Methods All MSM attending the Melbourne Sexual Health Centre (MSHC) in 2018 were included. Chart review was performed to determine the proportion of men vaccinated for at least one dose of hepatitis A and to examine why men did not receive the vaccine. Multivariable logistic regression was performed to examine the factors associated with vaccine uptake. Vaccine uptake was defined as receipt of at least one dose of hepatitis A vaccine.

Results Of the 9582 MSM who attended MSHC in 2018, 61.3% (95% CI 60.3% to 62.2%) self-reported already being immune to hepatitis A. Of the 3713 remaining eligible men, 62.7% (95% CI 61.1% to 64.2%) received at least one dose of the hepatitis A vaccine on the day of attendance. Compared with MSM not living with HIV and not taking pre-exposure prophylaxis (PrEP), MSM taking PrEP (adjusted OR 1.28; 95% CI 1.01 to 1.62) were more likely to receive the vaccine. 1386 men (37.3%) did not receive the vaccine and 55.4% were not offered the vaccine by their treating clinician. 300 men (21.6%) were identified as non-immune after serological testing but did not return for vaccination. By the end of 2018, 85.5% of MSHC attendees (8196/9582) were immune to hepatitis A.

Conclusion The critical vaccination threshold for hepatitis A has been estimated at >70%. Continuation of the targeted hepatitis A vaccination programme will improve immunity among the MSM population to prevent ongoing transmission and the likelihood of future outbreaks.

  • vaccine
  • prevention
  • behaviours
  • public health
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Footnotes

  • Handling editor Dr Joseph D Tucker

  • Presented at Some data of this work were presented as a poster presentation at the STI & HIV 2019 World Congress in Vancouver, Canada, 14 –17 July 2019.

  • Twitter Follow Eric Chow @EricPFChow

  • Contributors EPFC and CKF designed the study. SB conducted the analysis, performed the chart review and wrote the first draft of the manuscript. LAV and EPFC assisted with data analysis and interpretation. All authors were involved in data interpretation. All authors revised the manuscript critically for important intellectual content and approved the final version.

  • Funding This study is supported by the 2018 GSK Immunisation Grants (EP000784GSK).

  • Competing interests EPFC was supported by the National Health and Medical Research Council (NHMRC) Early Career Fellowships (1091226). All other authors declare no competing interests.

  • Patient consent for publication Not required.

  • Ethics approval This study was approved by the Alfred Hospital Ethics Committee, Melbourne, Australia (no. 669/18).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as online supplementary information.

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