Results of an enhanced-outreach programme of hepatitis B vaccination in the Netherlands (1998-2000) among men who have sex with men, hard drug users, sex workers and heterosexual persons with multiple partners.
OBJECTIVE
The Dutch Ministry of Health funded a pilot vaccination project targeting groups at high risk for sex- and drug-related hepatitis B transmission.


METHODS
In seven Municipal Health Service (MHS) areas, three-part hepatitis B vaccination was offered free to men who have sex with men (MSM), drug users (DUs), and heterosexuals with multiple partners, including sex workers (SWs). Four intervention areas recruited participants through care-givers and opinion leaders and offered vaccination at non-MHS sites. Three control areas only used flyers to offer vaccination at MHS during regular hours.


RESULTS
Over 18 months, 13808 persons enrolled for the first vaccination, representing 63% of the targeted population in the intervention areas and 23% in control areas. In intervention areas, only 19% of DUs enrolled, versus 4% in control areas. In both areas, enrollment of the targeted heterosexual population (64%) was satisfactory. MSM were most compliant in having the full series. Of vaccination sources, general practitioners (GPs) attained highest compliance (71%, odds ratio 1.82).


CONCLUSIONS
Dutch MHS facilities can reach high-risk individuals, but DUs require additional outreach. Vaccine coverage was disappointing, but our experience will be deployed nationwide and successful strategies might be employed elsewhere in countries of low endemicity.
van Steenbergen
Jim E
JE
Cluster Infectious Diseases, Municipal Health Service Amsterdam (GG&GD), Nieuwe Achtergracht 100, PO Box 2200, NL-1000 CE, Amsterdam, The Netherlands. jvsteenbergen@gggd.amsterdam.nl
D003159:Community-Institutional Relations; D017048:Health Care Costs; D006509:Hepatitis B / Q000453:epidemiology* / Q000517:prevention & control*; D017325:Hepatitis B Vaccines / Q000008:administration & dosage* / Q000191:economics; D020010:Heterosexuality / Q000706:statistics & numerical data*; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D032541:Mass Vaccination / Q000191:economics / Q000458:organization & administration; D009426:Netherlands / Q000453:epidemiology; D010349:Patient Compliance; D015397:Program Evaluation; D012307:Risk Factors; D011477:Sex Work / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000453:epidemiology*
D017325:Hepatitis B Vaccines