title: Molecular sequence data of hepatitis B virus and genetic diversity after vaccination.
abstract: The effect of vaccination programs on transmission of infectious disease is usually assessed by monitoring programs that rely on notifications of symptomatic illness. For monitoring of infectious diseases with a high proportion of asymptomatic cases or a low reporting rate, molecular sequence data combined with modern coalescent-based techniques offer a complementary tool to assess transmission. Here, the authors investigate the added value of using viral sequence data to monitor a vaccination program that was started in 1998 and was targeted against hepatitis B virus in men who have sex with men in Amsterdam, the Netherlands. The incidence in this target group, as estimated from the notifications of acute infections with hepatitis B virus, was low; therefore, there was insufficient power to show a significant change in incidence. In contrast, the genetic diversity, as estimated from the viral sequence collected from the target group, revealed a marked decrease after vaccination was introduced. Taken together, the findings suggest that introduction of vaccination coincided with a change in the target group toward behavior with a higher risk of infection. The authors argue that molecular sequence data provide a powerful additional monitoring instrument, next to conventional case registration, for assessing the impact of vaccination.
authors.affiliation: RIVM, National Institute for Public Health and the Environment, Bilthoven, The Netherlands. marijn.van.ballegooijen@rivm.nl
authors.forename: W Marijn
authors.initials: WM
authors.lastname: van Ballegooijen
authors.forename: Robin
authors.initials: R
authors.lastname: van Houdt
authors.forename: Sylvia M
authors.initials: SM
authors.lastname: Bruisten
authors.forename: Hein J
authors.initials: HJ
authors.lastname: Boot
authors.forename: Roel A
authors.initials: RA
authors.lastname: Coutinho
authors.forename: Jacco
authors.initials: J
authors.lastname: Wallinga
mesh_terms: D000208:Acute Disease; D001483:Base Sequence; D001499:Bayes Theorem; D004279:DNA, Viral / Q000235:genetics; D018563:Disease Notification; D014644:Genetic Variation; D006509:Hepatitis B / Q000453:epidemiology / Q000635:transmission / Q000821:virology*; D017325:Hepatitis B Vaccines; D006515:Hepatitis B virus / Q000235:genetics*; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008969:Molecular Sequence Data; D009426:Netherlands / Q000453:epidemiology
chemical_list: D004279:DNA, Viral; D017325:Hepatitis B Vaccines