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Hepatitis B immunization coverage and risk behaviour among Danish travellers: are immunization strategies based on
Ulla Schierup Nielsen1, Eskild Petersen, Carsten Schade Larsen
1Department of Infectious Diseases, Aarhus University Hospital Skejby, Brendstrupgaardsvej 100, Aarhus N, Denmark. ullanise@rm.dk
Objectives:
The authors examine the rationale and efficacy of pre-travel hepatitis B immunization strategies based on itinerary and presumed on-travel risk behaviour.
Methods:
A large survey among 26,640 Danes survey provided data on journey lengths and destinations, immunization coverage, risk behaviour and knowledge.
Results:
The estimated cumulative lifetime stay in endemic areas outside Europe is 4.3 months. The majority of risk situations are involuntary and unforeseeable. The majority of risk situations occur on short-term journeys. 5% nonimmune and 5% short-term travellers experienced at least one risk situation such as injections/operations/tattoos on their journey. The level of knowledge of hepatitis A and B is low.
Conclusions:
The rationale and efficacy of current immunization strategies are challenged. Based on the results presented here and the availability of vaccines with long-lasting coverage, the authors find that recommendations of immunization should be based on lifetime risk instead of single journey itineraries. The authors find that a recommendation and/or cost-benefit discussion would be relevant in the pre-travel counselling of most - especially younger - travellers to endemic areas.
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