Self-reported Hepatitis A and B Vaccination Coverage Among Men Who Have Sex with Men (MSM), Associated Factors and Vaccination Recommendations in 43 Countries of the WHO European Region: Results from the European MSM Internet Survey, EMIS-2017

Overview

Journal Euro Surveill

Specialty Infectious Diseases

Date 2024 Nov 8

PMID 39512170

Authors

Michael Brandl

Axel J Schmidt

Ulrich Marcus

Erika Duffell

Ettore Severi

Antons Mozalevskis

Anda kivite-Urtane

Matthias An der Heiden

Sandra Dudareva

Affiliations

Soon will be listed here.

Abstract

BackgroundHepatitis A and B vaccinations are recommended for men who have sex with men (MSM), given their increased risk of infection. However, data on vaccination programmes are scarce.AimTo use information on vaccination recommendations and vaccine uptake among MSM in the WHO European Region to guide prevention.MethodsFrom a large pan-European MSM Internet Survey (EMIS-2017), we analysed data on self-reported hepatitis A and B vaccination status by age, education, financial coping, settlement size, outness (disclosure of sexual behaviour), migration history and diagnosis with hepatitis C or HIV, using multivariable logistic regression. Additionally, we collected information on national hepatitis A and B vaccination recommendations.ResultsWe present data of 113,884 MSM, median age 36 years (IQR: 27-47). Vaccination for hepatitis A and B was recommended and free for MSM in 7 and 18 of 43 countries, respectively. Of all respondents, 48% (n = 50,966) reported ever being vaccinated against hepatitis A, and 53% (n = 56,889) against hepatitis B. Odds for being vaccinated against hepatitis A increased with outness ('out to (almost) all' aOR: 1.78, 95% CI: 1.72-1.85 vs 'out to none') and were higher in countries where vaccination was recommended and free for MSM (aOR: 2.22, 95% CI: 1.29-3.82 vs 'no recommendation'). Results for hepatitis B were similar (outness: aOR: 1.81, 95% CI: 1.75-1.88 and MSM-specific vaccination recommendation: aOR: 2.44, 95% CI: 1.54-3.85).ConclusionLarge proportions of MSM in Europe remain vulnerable to hepatitis A and B, despite available vaccination. Implementation of MSM-specific vaccination recommendations and greater efforts to improve the societal climate for MSM are needed to address gaps in vaccine coverage.

References

Friesema I, Sonder G, Petrignani M, Meiberg A, van Rijckevorsel G, Ruijs W . Spillover of a hepatitis A outbreak among men who have sex with men (MSM) to the general population, the Netherlands, 2017. Euro Surveill. 2018; 23(23). PMC: 6152169. DOI: 10.2807/1560-7917.ES.2018.23.23.1800265. View

Mereckiene J, Cotter S, Lopalco P, DAncona F, Levy-Bruhl D, Giambi C . Hepatitis B immunisation programmes in European Union, Norway and Iceland: where we were in 2009?. Vaccine. 2010; 28(28):4470-7. DOI: 10.1016/j.vaccine.2010.04.037. View

Vet R, de Wit J, Das E . Factors associated with hepatitis B vaccination among men who have sex with men: a systematic review of published research. Int J STD AIDS. 2015; 28(6):534-542. DOI: 10.1177/0956462415613726. View

Pattyn J, Hendrickx G, Vorsters A, Van Damme P . Hepatitis B Vaccines. J Infect Dis. 2021; 224(12 Suppl 2):S343-S351. PMC: 8482019. DOI: 10.1093/infdis/jiaa668. View

Jacobsen K . Globalization and the Changing Epidemiology of Hepatitis A Virus. Cold Spring Harb Perspect Med. 2018; 8(10). PMC: 6169986. DOI: 10.1101/cshperspect.a031716. View

Seto W, Lo Y, Pawlotsky J, Yuen M . Chronic hepatitis B virus infection. Lancet. 2018; 392(10161):2313-2324. DOI: 10.1016/S0140-6736(18)31865-8. View

Linder K, Malani P . Hepatitis A. JAMA. 2017; 318(23):2393. DOI: 10.1001/jama.2017.17244. View

Khetsuriani N, Mosina L, Van Damme P, Mozalevskis A, Datta S, Tohme R . Progress Toward Hepatitis B Control - World Health Organization European Region, 2016-2019. MMWR Morb Mortal Wkly Rep. 2021; 70(30):1029-1035. PMC: 8323554. DOI: 10.15585/mmwr.mm7030a1. View

Xiridou M, Adam P, Meiberg A, Visser M, Matser A, de Wit J . The impact of the COVID-19 pandemic on hepatitis B virus vaccination and transmission among men who have sex with men: A mathematical modelling study. Vaccine. 2022; 40(33):4889-4896. PMC: 9250904. DOI: 10.1016/j.vaccine.2022.06.075. View

10.

Schmidt A, Rasi M, Esson C, Christinet V, Ritzler M, Lung T . The Swiss STAR trial - an evaluation of target groups for sexually transmitted infection screening in the sub-sample of men. Swiss Med Wkly. 2020; 150:w20392. DOI: 10.4414/smw.2020.20392. View

11.

Lernout T, Hendrickx G, Vorsters A, Mosina L, Emiroglu N, Van Damme P . A cohesive European policy for hepatitis B vaccination, are we there yet?. Clin Microbiol Infect. 2014; 20 Suppl 5:19-24. DOI: 10.1111/1469-0691.12535. View

12.

Pachankis J, Hatzenbuehler M, Hickson F, Weatherburn P, Berg R, Marcus U . Hidden from health: structural stigma, sexual orientation concealment, and HIV across 38 countries in the European MSM Internet Survey. AIDS. 2015; 29(10):1239-46. PMC: 4820755. DOI: 10.1097/QAD.0000000000000724. View

13.

Miglietta A, Quinten C, Lopalco P, Duffell E . Impact of hepatitis B vaccination on acute hepatitis B epidemiology in European Union/European Economic Area countries, 2006 to 2014. Euro Surveill. 2018; 23(6). PMC: 5824123. DOI: 10.2807/1560-7917.ES.2018.23.6.17-00278. View

14.

Rezayatmand R, Pavlova M, Groot W . The impact of out-of-pocket payments on prevention and health-related lifestyle: a systematic literature review. Eur J Public Health. 2012; 23(1):74-9. DOI: 10.1093/eurpub/cks034. View

15.

Rolnick S, Parker E, Nordin J, Hedblom B, Wei F, Kerby T . Self-report compared to electronic medical record across eight adult vaccines: do results vary by demographic factors?. Vaccine. 2013; 31(37):3928-35. PMC: 4689428. DOI: 10.1016/j.vaccine.2013.06.041. View

16.

Zhang X, Ong J, MacGregor L, Vilaplana T, Heathcock S, Mindlin M . Transmission dynamics of the 2016-18 outbreak of hepatitis A among men who have sex with men in England and cost-effectiveness analysis of vaccination strategies to prevent future outbreaks. Lancet Reg Health Eur. 2022; 19:100426. PMC: 9417902. DOI: 10.1016/j.lanepe.2022.100426. View

17.

Velan B, Yadgar Y . On the implications of desexualizing vaccines against sexually transmitted diseases: health policy challenges in a multicultural society. Isr J Health Policy Res. 2017; 6(1):30. PMC: 5493887. DOI: 10.1186/s13584-017-0153-4. View

18.

Shouval D . Immunization against Hepatitis A. Cold Spring Harb Perspect Med. 2018; 9(2). PMC: 6360863. DOI: 10.1101/cshperspect.a031682. View

19.

Pachankis J, Hatzenbuehler M, Berg R, Fernandez-Davila P, Mirandola M, Marcus U . Anti-LGBT and Anti-immigrant Structural Stigma: An Intersectional Analysis of Sexual Minority Men's HIV Risk When Migrating to or Within Europe. J Acquir Immune Defic Syndr. 2017; 76(4):356-366. PMC: 5659919. DOI: 10.1097/QAI.0000000000001519. View

20.

Maqsood Q, Sumrin A, Iqbal M, Younas S, Hussain N, Mahnoor M . Hepatitis C virus/Hepatitis B virus coinfection: Current prospectives. Antivir Ther. 2023; 28(4):13596535231189643. DOI: 10.1177/13596535231189643. View