title: Evaluation of a temporary vaccination recommendation in response to an outbreak of invasive meningococcal serogroup C disease in men who have sex with men in Berlin, 2013-2014.
abstract: Meningococcal serogroup C (MenC) vaccination of men who have sex with men (MSM) was temporarily recommended to control an outbreak of invasive MenC disease among MSM in Berlin in 2012-2013. Vaccination was offered to HIV-infected MSM free of charge; others had to request reimbursement or pay out of pocket. We aimed to assess (i) awareness and acceptance of this recommendation through an online survey of MSM, (ii) implementation through a survey of primary care physicians and analysis of vaccine prescriptions, and (iii) impact through analysis of notified cases. Among online survey respondents, 60% were aware of the recommendation. Of these, 39% had obtained vaccination (70% of HIV-infected, 13% of HIV-negative/non-tested MSM). Awareness of recommendation and vaccination were positively associated with HIV infection, primary care physicians' awareness of respondents' sexual orientation, and exposure to multiple information sources. Most (26/30) physicians informed clients about the recommendation. Physicians considered concerns regarding reimbursement, vaccine safety and lack of perceived disease risk as primary barriers. After the recommendation, no further outbreak-related cases occurred. To reach and motivate target groups, communication of a new outbreak-related vaccination recommendation should address potential concerns through as many information channels as possible and direct reimbursement of costs should be enabled.
authors.affiliation: Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany.
authors.forename: Judith
authors.initials: J
authors.lastname: Koch
authors.forename: Wiebke
authors.initials: W
authors.lastname: Hellenbrand
authors.forename: Susanne
authors.initials: S
authors.lastname: Schink
authors.forename: Ole
authors.initials: O
authors.lastname: Wichmann
authors.forename: Andreas
authors.initials: A
authors.lastname: Carganico
authors.forename: Jochen
authors.initials: J
authors.lastname: Drewes
authors.forename: Martin
authors.initials: M
authors.lastname: Kruspe
authors.forename: Marlen
authors.initials: M
authors.lastname: Suckau
authors.forename: Heike
authors.initials: H
authors.lastname: Claus
authors.forename: Ulrich
authors.initials: U
authors.lastname: Marcus
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001604:Berlin / Q000453:epidemiology; D004196:Disease Outbreaks; D005858:Germany; D019538:Health Care Surveys; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008589:Meningococcal Infections / Q000453:epidemiology*; D022401:Meningococcal Vaccines / Q000008:administration & dosage*; D008875:Middle Aged; D009305:Nasopharynx / Q000382:microbiology; D038542:Neisseria meningitidis, Serogroup C / Q000276:immunology / Q000302:isolation & purification*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D015995:Prevalence; D015397:Program Evaluation; D012747:Sexual Partners; D014611:Vaccination / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D022401:Meningococcal Vaccines
keywords: Neisseria meningitidis (Nm); evaluation; men who have sex with men (MSM); outbreak control; survey; vaccine recommendation