Top

Published in:

Open Access 01-12-2021 | Hepatitis B | Research

Hepatitis B vaccination coverage in Germany: systematic review

Authors: Gyde Steffen, Ida Sperle, Thomas Harder, Navina Sarma, Sandra Beermann, Roma Thamm, Viviane Bremer, Ruth Zimmermann, Sandra Dudareva

Published in: BMC Infectious Diseases | Issue 1/2021

Abstract

Background

Despite being considered as a low prevalence country for hepatitis B (HBV), some populations in Germany are at higher risk of infection. In the context of the World Health Organization’s (WHO) viral hepatitis elimination goals, a valid epidemiological data base is needed to plan and monitor the national response. Prevention strategies include general and targeted HBV vaccination programmes.

Objective

The aim of this work was to estimate the HBV vaccination coverage (VC) in the general population (GP) and different population groups in Germany from available evidence and to identify current evidence gaps for future research.

Methods

We conducted a systematic review on HBV VC in the general population and populations at high risk of HBV exposure or severe infection in Germany. We included eligible publications (01/01/2017 to 06/06/2020) from databases Embase, Pubmed and Livivo, from a previous scoping review (including data published 01/01/2005–17/03/2017), from the national surveillance system and screened the reference lists of all publications at full text level. Risk of bias was assessed using the Hoy et al. tool.

Results

We included 68 publications of 67 studies and assigned them to one or more suitable population groups. Twenty-one studies contained data among children/adolescents and three among adults from the GP (VC 65.8–90.5% and 22.9–52.1%, respectively), one among travelers (VC 89.0%), 13 among immunocompromised populations (VC 7.8–89.0%), 16 among populations with occupational risk and 16 with non-occupational risk of HBV exposure (VC 63.6–96.5% and 4.4–84.5%, respectively).

Conclusion

Comprehensive evidence at low risk of bias was identified for children/adolescents. However, 25 years after including HBV in the national immunisation schedule, VC in Germany is still below the 95%-goal defined by WHO. For people at occupational risk of HBV exposure, VC was mostly reported to be over the WHO goal of 80%, but quality of evidence was heterogenous and should be improved. For people at non-occupational risk of HBV exposure, evidence was sparse and of low quality. The low VC highlights the need for future research to plan vaccination programmes targeting these populations.

Available only for authorised users

World Health Organization (WHO), Regional Office for Europe. Hepatitis B in the WHO European Region. Fact sheet – July 2019. 2019. Available from: https://www.euro.who.int/__data/assets/pdf_file/0007/377251/Fact-Sheet-Hepatitis-B_2019-ENG.pdf.

Poethko-Müller C, Zimmermann R, Hamouda O, Faber M, Stark K, Ross RS, et al. Epidemiology of hepatitis A, B, and C among adults in Germany: results of the German health interview and examination survey for adults (DEGS1). Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz. 2013;56(5–6):707–15. https://doi.org/10.1007/s00103-013-1673-x.CrossRef

Falla AM, Hofstraat SHI, Duffell E, Hahné SJM, Tavoschi L, Veldhuijzen IK. Hepatitis B/C in the countries of the EU/EEA: a systematic review of the prevalence among at-risk groups. BMC Infect Dis. 2018;18(1):79. https://doi.org/10.1186/s12879-018-2988-x.CrossRefPubMedPubMedCentral

Tavoschi L, Mason L, Petriti U, Bunge E, Veldhuijzen I, Duffell E. Hepatitis B and C among healthcare workers and patient groups at increased risk of iatrogenic transmission in the European Union/European economic area. J Hosp Infect. 2019;102(4):359–68. https://doi.org/10.1016/j.jhin.2019.03.004.CrossRefPubMedPubMedCentral

Ahmad AA, Falla AM, Duffell E, Noori T, Bechini A, Reintjes R, et al. Estimating the scale of chronic hepatitis B virus infection among migrants in EU/EEA countries. BMC Infect Dis. 2018;18(1):34. https://doi.org/10.1186/s12879-017-2921-8.CrossRefPubMedPubMedCentral

World Health Organization. Global and country estimates of immunization coverage and chronic HBV infection. Geneva: World Health Organization; 2020. Available from: http://whohbsagdashboard.com/#global-strategies.

Sperle I, Steffen G, Leendertz SA, Sarma N, Beermann S, Thamm R, et al. Prevalence of hepatitis B, C, and D in Germany: results from a scoping review. Front Public Health. 2020;8:424. https://doi.org/10.3389/fpubh.2020.00424.CrossRefPubMedPubMedCentral

Ständige Impfkommission (STIKO). Statement of the German Standing Committee on Vaccination at the RKIRecommendations of the Standing Committee on Vaccination (STIKO) at the Robert Koch Institute – 2017/2018. Epidemiol Bull. 2017;34:333–76.

Harder T, Remschmidt C, Falkenhorst G, Zimmermann R. Background paper to the revised recommendation for hepatitis B vaccination of persons at particular risk and for hepatitis B postexposure prophylaxis in Germany. Bundesgesundheitsbl. 2013;56(11):1565–76. https://doi.org/10.1007/s00103-013-1845-8.CrossRef

10.

(WHO) WHO. European vaccine action plan 2015-2020. Copenhagen: WHO; 2014.

11.

World Health Organization Regional Office for Europe. Action plan for the health sector response to viral hepatitis in the WHO European Region. Denmark: WHO Regional Office for Europe; 2017.

12.

Bundesministerium für Gesundheit, Bundesministerium für wirtschaftliche Zusammenarbeit und Entwicklung. Strategie zur Eindämmung von HIV, Hepatitis B und C und anderen sexuell übertragbaren Infektionen. Bis 2030 - Bedarfsorientiert · Integriert · Sektorübergreifend. Berlin: Bundesministerium für Gesundheit, Bundesministerium für wirtschaftliche Zusammenarbeit und Entwicklung; 2016. Available from: https://www.bundesgesundheitsministerium.de/fileadmin/Dateien/5_Publikationen/Praevention/Broschueren/Strategie_BIS_2030_HIV_HEP_STI.pdf.

13.

Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Open Med. 2009;3(3):e123–30.PubMedPubMedCentral

14.

Steffen G, Sperle I, Leendertz SA, Sarma N, Beermann S, Thamm R, et al. The epidemiology of hepatitis B, C and D in Germany: a scoping review. PLoS One. 2020;15(3):e0229166. https://doi.org/10.1371/journal.pone.0229166.CrossRefPubMedPubMedCentral

15.

Ständige Impfkommission (STIKO). Empfehlungen der Ständigen Impfkommission (STIKO) am Robert Koch-Institut. Epid Bull. 2017;34:333–76.

16.

Hoy D, Brooks P, Woolf A, Blyth F, March L, Bain C, et al. Assessing risk of bias in prevalence studies: modification of an existing tool and evidence of interrater agreement. J Clin Epidemiol. 2012;65(9):934–9. https://doi.org/10.1016/j.jclinepi.2011.11.014.CrossRefPubMed

17.

Bader H-M. Zu Impfungen bei Kindern im Alter bis zu 24 Monaten. Epidemiol Bull. 2007;34:316-21.

18.

Bader H-M, Egler P. Impfschutz bei Erwachsenen in Schleswig-Holstein 2011 – ein update nach acht Jahren. Epidemiol Bull. 2013;22:197-203.

19.

Bader H-M, Heiser A. Zum Impfschutz bei Aufnahme in den Kindergarten in Schleswig-Holstein im Jahr 2009. Epidemiol Bull. 2011;7:49-53.

20.

Bader H-M, Rasche S. Impfschutz bei Aufnahme in den Kindergarten Schleswig-Holstein 2006. Schleswig-Holsteinisches Arztebl. 2007;9:45-49.

21.

Brandl M, Schmidt AJ, Marcus U, An Der Heiden M, Dudareva S. Are men who have sex with men in Europe protected from hepatitis B? Epidemiol Infect. 2020;148-e27.

22.

Cagol L, Seitel T, Ehrenberg S, Frivolt K, Krahl A, Lainka E, et al. Vaccination rate and immunity of children and adolescents with inflammatory bowel disease or autoimmune hepatitis in Germany. Vaccine. 2020;38(7):1810–7. https://doi.org/10.1016/j.vaccine.2019.12.024.CrossRefPubMed

23.

Claus M, Kimbel R, Schöne K, Letzel S, Rose DM. Seroepidemiology of hepatitis A and B and vaccination status in staff at German schools for the handicapped. J Med Virol. 2016;89(5):825-833.

24.

Hampel A, Solbach P, Cornberg M, Schmidt RE, Behrens GM, Jablonka A. [Current seroprevalence, vaccination and predictive value of liver enzymes for hepatitis B among refugees in Germany]. Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 2016;59(5):578–583. https://doi.org/10.1007/s00103-016-2333-8.

25.

Haussig JM, Nielsen S, Gassowski M, Bremer V, Marcus U, Wenz B, et al. A large proportion of people who inject drugs are susceptible to hepatitis B: results from a bio-behavioural study in eight German cities. Int J Infect Dis. 2018;66:5–13. https://doi.org/10.1016/j.ijid.2017.10.008.CrossRefPubMed

26.

Heidrich B, Cetindere A, Beyaz M, Stahmeyer JT, Basaran MM, Braynis B, et al. High prevalence of hepatitis markers in immigrant populations: a prospective screening approach in a real-world setting. Eur J Gastroenterol Hepatol. 2014;26(10):1090–7. https://doi.org/10.1097/MEG.0000000000000164.CrossRefPubMed

27.

Herta T, Petroff D, Engelmann C, Herber A, Aehling N, Scheuermann U, et al. Hepatitis b vaccination in patients with liver cirrhosis evaluated for liver transplantation - a simple intervention ensures high adherence. Ann Transplant. 2019;24:527–31. https://doi.org/10.12659/AOT.917198.CrossRefPubMedPubMedCentral

28.

Jablonka A, Solbach P, Wöbse M, Manns MP, Schmidt RE, Wedemeyer H, et al. Seroprevalence of antibodies and antigens against hepatitis A-E viruses in refugees and asylum seekers in Germany in 2015. Eur J Gastroenterol Hepatol. 2017;29(8):939–45. https://doi.org/10.1097/MEG.0000000000000889.CrossRefPubMed

29.

Jansen K, Thamm M, Bock C-T, Scheufele R, Kücherer C, Muenstermann D, et al. High prevalence and high incidence of coinfection with hepatitis B, hepatitis C, and syphilis and low rate of effective vaccination against hepatitis B in HIV-positive men who have sex with men with known date of HIV seroconversion in Germany. PLoS One. 2015;10(11):e0142515. https://doi.org/10.1371/journal.pone.0142515.CrossRefPubMedPubMedCentral

30.

Karnaki P, Baka A, Petralias A, Veloudaki A, Zota D, Linos A. Immunization related behaviour among healthcare workers in Europe: results of the HProImmune survey. Cent Eur J Public Health. 2019;27(3):204–11. https://doi.org/10.21101/cejph.a5514.CrossRefPubMed

31.

Kiltz U, Celik A, Tsiami S, Bühring B, Baraliakos X, Braun J. Gaps in patient safety performance in patients with immunosuppressive therapy: results of screening for infections and vaccination status in a large real-life cohort. Ann Rheum Dis. 2019;78:1377–8.

32.

Kloning T, Nowotny T, Alberer M, Hoelscher M, Hoffmann A, Froeschl G. Morbidity profile and sociodemographic characteristics of unaccompanied refugee minors seen by paediatric practices between October 2014 and February 2016 in Bavaria, Germany. BMC Public Health. 2018;18(1):983. https://doi.org/10.1186/s12889-018-5878-7.CrossRefPubMedPubMedCentral

33.

Kortas AZ, Polenz J, von Hayek J, Rüdiger S, Rottbauer W, Storr U, et al. Screening for infectious diseases among asylum seekers newly arrived in Germany in 2015: a systematic single-Centre analysis. Public Health. 2017;153:1–8. https://doi.org/10.1016/j.puhe.2017.07.011.CrossRefPubMed

34.

Krasselt M, Baerwald C, Seifert O. Insufficient vaccination rates in patients with systemic lupus erythematosus in a German outpatient clinic. Z Rheumatol. 2018;77(8):727–34. https://doi.org/10.1007/s00393-017-0410-5.CrossRefPubMed

35.

Krasselt M, Ivanov JP, Baerwald C, Seifert O. Low vaccination rates among patients with rheumatoid arthritis in a German outpatient clinic. Rheumatol Int. 2017;37(2):229–37. https://doi.org/10.1007/s00296-016-3608-y.CrossRefPubMed

36.

Marquardt L, Krämer A, Fischer F, Prüfer-Krämer L. Health status and disease burden of unaccompanied asylum-seeking adolescents in Bielefeld, Germany: cross-sectional pilot study. Tropical Med Int Health. 2016;21(2):210–8. https://doi.org/10.1111/tmi.12649.CrossRef

37.

Matysiak-Klose D. Robert Koch-Institut (RKI). Impfquoten bei der Schuleingangsuntersuchung in Deutschland 2015. Epidemiol Bull. 2017;2017(16):137–42.

38.

Mikolajczyk RT, Akmatov MK, Stich H, Krämer A, Kretzschmar M. Association between acculturation and childhood vaccination coverage in migrant populations: a population based study from a rural region in Bavaria, Germany. Int J Public Health. 2008;53(4):180–7. https://doi.org/10.1007/s00038-008-8002-4.CrossRefPubMed

39.

Neufeind J, Betsch C, Habersaat KB, Eckardt M, Schmid P, Wichmann O. Barriers and drivers to adult vaccination among family physicians - insights for tailoring the immunization program in Germany. Vaccine. 2020;38(27):4252–62. https://doi.org/10.1016/j.vaccine.2020.04.052.CrossRefPubMed

40.

Poethko-Müller C, Kuhnert R, Gillesberg Lassen S, Siedler A. [Vaccination coverage of children and adolescents in Germany: new data from KiGGS wave 2 and trends from the KiGGS study]. Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 2019;62(4):410–421. https://doi.org/10.1007/s00103-019-02901-5.

41.

Poethko-Müller C, Kuhnert R, Schlaud M. Vaccination coverage and predictors for vaccination level: results of the German health interview and examination survey for children and adolescents (KiGGS). Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz. 2007;50(5–6):851–62. https://doi.org/10.1007/s00103-007-0248-0.CrossRef

42.

Poethko-Muller C, Schmitz R. Vaccination coverage in German adults: results of the German health interview and examination survey for adults (DEGS1). Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz. 2013;56(5–6):845–57. https://doi.org/10.1007/s00103-013-1693-6.CrossRef

43.

Ramich T, Eickholz P, Wicker S. Work-related infections in dentistry: risk perception and preventive measures. Clin Oral Investig. 2017;21(8):2473–9. https://doi.org/10.1007/s00784-017-2046-x.CrossRefPubMed

44.

Rieck T. Impfquoten bei der Schuleingangsuntersuchung in Deutschland 2017. Epidemiol Bull. 2019;18:147–53.

45.

Rieck T, Feig M, Eckmanns T, Benzler J, Siedler A, Wichmann O. Vaccination coverage among children in Germany estimated by analysis of health insurance claims data. Hum Vaccin Immunother. 2014;10(2):476–84. https://doi.org/10.4161/hv.26986.CrossRefPubMed

46.

Rieck T, Robert Koch-Institut (RKI). Impfquoten bei der Schuleingangsuntersuchung in Deutschland 2011. Epidemiol Bull. 2013;2013(16):129–33.

47.

Robert Koch-Institut. Impfquoten bei der Schuleingangsuntersuchung in Deutschland 2016. Epidemiol Bull. 2018;16:151-56.

48.

Scherbaum N, Timm J, Richter F, Bonnet U, Bombeck J, Lajos S, et al. Outcome of a hepatitis B vaccination program for clients of a drug consumption facility. J Clin Virol. 2018;106:28–32. https://doi.org/10.1016/j.jcv.2018.04.014.CrossRefPubMed

49.

Schuster T, Borgmann-Staudt A, Konig CJ, Sommerhauser G, Korte E, Holling H, et al. Vaccinations and screening examinations – prevention awareness among children of childhood cancer survivors in Germany Impfungen und Vorsorgeuntersuchungen – Präventionsverhalten bei Nachkommen ehemaliger kinderonkologischer Patienten in Deutschland. Klin Padiatr. 2020;232(3):143–50. https://doi.org/10.1055/a-1114-6350.CrossRefPubMed

50.

Spinner CD, Boesecke C, Jordan C, Wyen C, Kümmerle T, Knecht G, et al. Prevalence of asymptomatic sexually transmitted infections in HIV-positive men who have sex with men in Germany: results of a multicentre cross-sectional study. Infection. 2018;46(3):341–7. https://doi.org/10.1007/s15010-018-1124-6.CrossRefPubMed

51.

Teich N, Klugmann T, Tiedemann A, Holler B, Mössner J, Liebetrau A, et al. Vaccination coverage in immunosuppressed patients: results of a regional health services research study. Dtsch Arztebl Int. 2011;108(7):105–11.PubMedPubMedCentral

52.

Weltermann B, Herwig A, Dehnen D, Herzer K. Vaccination status of pneumococcal and other vaccines in 444 liver transplant patients compared to a representative population sample. Ann Transplant. 2016;21:200–7. https://doi.org/10.12659/AOT.896436.CrossRefPubMed

53.

Wilckens V, Kannengiesser K, Hoxhold K, Frenkel C, Kucharzik T, Maaser C. The immunization status of patients with IBD is alarmingly poor before the introduction of specific guidelines. Scand J Gastroenterol. 2011;46(7–8):855–61. https://doi.org/10.3109/00365521.2011.574734.CrossRefPubMed

54.

Bödecker B, Neufeind J, O W OKAPII: Influenza-Impfquoten-monitoring im Krankenhaus. Epidemiol Bull. 2019;44:467–69.

55.

Baars S. Prävalenz von Hepatitis B und C bei medizinischen Fachangestellten. Göttingen: Niedersächsische Gewerbeaufsicht; 2011. Available from: https://www.gewerbeaufsicht.niedersachsen.de/startseite/arbeitsschutz/arbeitsmedizin/schwerpunktaktionen/praevalenz-von-hepatitis-b-und-hepatitis-c-bei-medizinischen-fachangestellten-117845.html.

56.

Bigl S, Schreiber M, Kötz I. Impfraten von Auszubildenden der Kranken- und Altenpflege. Ärtzeblatt Sachsen. 2011;10(2011):527–31.

57.

Burckhardt F, Deleré Y, Wiese-Posselt M. Impfstatus sowie Einstellung und Verhalten von Hebammen zu Impfungen – Ergebnisse einer Querschnittsstudie. Epidemiol Bull. 2008;2008(21):163–9.

58.

Darstein F. Prävalenz und Risikofaktoren von Hepatitis B und C bei Patienten einer Berliner Rettungsstelle; eine analytische Querschnittstudie; prevalence and risk factors for hepatitis B and C among patients attending a German Emergency Department; an analytical cross-sectional study. Berlin: Freie Universität Berlin; 2015. Available from: https://refubium.fu-berlin.de/discover?filtertype_0=mycoreId&filter_relational_operator_0=equals&filter_0=FUDISS_thesis_000000098571.

59.

Deterding K, Heidelberger S, Wiebner B, Meining K, Cornberg MP, Manns M, et al. Knowledge and management of hepatitis B virus infected patients in Germany. Dtsch Med Wochenschr. 2012;137(15):774–9. https://doi.org/10.1055/s-0032-1304852.CrossRefPubMed

60.

Feuchtenberger M, Schäfer A, Philipp Nigg A, Rupert Kraus M. Hepatitis B serology in patients with rheumatic diseases. Open Rheumatol J. 2016;10:39–48 Available from: http://europepmc.org/abstract/MED/27708728http://europepmc.org/articles/PMC5039958?pdf=render. http://europepmc.org/articles/PMC5039958. https://doi.org/10.2174/1874312901610010039. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5039958/pdf/TORJ-10-39.pdf.CrossRef

61.

Heywood AE, Nothdurft H, Tessier D, Moodley M, Rombo L, Marano C, et al. Pre-travel advice, attitudes and hepatitis A and B vaccination rates among travellers from seven countriesdagger. J Travel Med. 2016;24(1):1-8.

62.

Lutgehetmann M, Meyer F, Volz T, Lohse AW, Fischer C, Dandri M, et al. Knowledge about HBV, prevention behaviour and treatment adherence of patients with chronic hepatitis B in a large referral Centre in Germany. Z Gastroenterol. 2010;48(9):1126–32. https://doi.org/10.1055/s-0029-1245304.CrossRefPubMed

63.

Mäding C, Jacob C, Münch C, Von Lindeman K, Klewer J, Kugler J. Vaccination coverage among students from a German health care college. Am J Infect Control. 2015;43(2):191–4. https://doi.org/10.1016/j.ajic.2014.10.019.CrossRefPubMed

64.

Mone JS. Untersuchungen zur nicht bestimmungsgemäßen Verwendung von Substitutionsmitteln und zum Gesundheitszustand von substituierten und nicht substituierten Opiatabhängigen in Deutschland. Hamburg: Universität Hamburg; 2015. Available from: https://ediss.sub.uni-hamburg.de/handle/ediss/6581.

65.

Müller MC, Pichler M, Martin G, Plörer D, Winter C, Pogarell O, et al. Burden of disease and level of patient’s medical care in substitution treatment for opiates. Med Klin. 2009;104(12):913–7. https://doi.org/10.1007/s00063-009-1196-2.CrossRef

66.

Reiter S, Robert Koch-Institut (RKI). Impfquoten bei der Schuleingangsuntersuchung in Deutschland 2005. Epidemiol Bull. 2006;2006(48):430–1.

67.

Reiter S, Robert Koch-Institut (RKI). Zu den Impfquoten bei den Schuleingangsuntersuchungen in Deutschland 2006. Epidemiol Bull. 2008;2008(7):55–7.

68.

Reiter S, Robert Koch-Institut (RKI). Impfquoten bei den Schuleingangsuntersuchungen in Deutschland 2007. Epidemiol Bull. 2009;2009(16):143–5.

69.

Reiter S, Robert Koch-Institut (RKI). Impfquoten bei den Schuleingangsuntersuchungen in Deutschland 2008. Epidemiol Bull. 2010;2010(16):137–40.

70.

Reiter S, Robert Koch-Institut (RKI). Impfquoten bei den Schuleingangsuntersuchungen in Deutschland 2009. Epidemiol Bull. 2011;2011(16):125–9.

71.

Reiter S, Robert Koch-Institut (RKI). Impfquoten bei der Schuleingangsuntersuchung in Deutschland 2010. Epidemiol Bull. 2012;2012(16):135–9.

72.

Reuter S, Oette M, Wilhelm FC, Beggel B, Kaiser R, Balduin M, et al. Prevalence and characteristics of hepatitis B and C virus infections in treatment-naïve HIV-infected patients. Med Microbiol Immunol. 2011;200(1):39–49. https://doi.org/10.1007/s00430-010-0172-z.CrossRefPubMed

73.

Rieck T, Robert Koch-Institut (RKI). Impfquoten bei der Schuleingangsuntersuchung in Deutschland 2012. Epidemiol Bull. 2014;2014(16):137–41.

74.

Rieck T, Robert Koch-Institut (RKI). Impfquoten bei der Schuleingangsuntersuchung in Deutschland 2013. Epidemiol Bull. 2015;2015(16):131–5.

75.

Rieck T, Robert Koch-Institut (RKI). Impfquoten bei der Schuleingangsuntersuchung in Deutschland 2014. Epidemiol Bull. 2016;2016(16):129–33.

76.

Schmid K, Merkl K, Hiddemann-Koca K, Drexler H. Obligatory occupational health check increases vaccination rates among medical students. J Hosp Infect. 2008;70(1):71–5. https://doi.org/10.1016/j.jhin.2008.05.010.CrossRefPubMed

77.

Schmidt CS, Schön D, Schulte B, Lüth S, Polywka S, Reimer J. Viral hepatitis in alcohol-dependent inpatients prevalence, risk factors, and treatment uptake. J Addict Med. 2013;7(6):417–21. https://doi.org/10.1097/ADM.0b013e3182a50817.CrossRefPubMed

78.

Voigt K, Kuhne F, Twork S, Gobel A, Kugler J, Bergmann A. Current vaccination status of health-care personnel in Brandenburg, Saxony and Saxony-Anhalt. Gesundheitswesen. 2008;70(7):408–14. https://doi.org/10.1055/s-0028-1082077.CrossRefPubMed

79.

Voigt K, Rühle F, Bergmann A, Schübel J, Hirsch K, Riemenschneider H. Vaccination status among nurses in hospitals. Results of a cross sectional study at Harzklinikum Dorothea Christiane Erxleben Quedlinburg. Pflege. 2016;29(4):205–12. https://doi.org/10.1024/1012-5302/a000497.CrossRefPubMed

80.

von Lindeman K, Kugler J, Klewer J. Vaccinations among students in health care professions. Pflege Zeitschrift. 2011;64(12):740–3.

81.

Wicker S, Rabenau HF, Doerr HW, Allwinn R. Are medical students sufficiently vaccinated? LaboratoriumsMedizin. 2009;33(4):223–7. https://doi.org/10.1515/JLM.2009.035.CrossRef

82.

Wicker S, Rabenau HF, Gottschalk R, Doerr HW, Allwinn R. Seroprevalence of vaccine preventable and blood transmissible viral infections (measles, mumps, rubella, polio, HBV, HCV and HIV) in medical students. Med Microbiol Immunol. 2007;196(3):145–50. https://doi.org/10.1007/s00430-007-0036-3.CrossRefPubMed

83.

Wicker S, Rabenau HF, Klemstein S, Gottschalk R. Needlestick injuries in emergency medical services. Anästhesiol Intensivmed. 2010;51(8):456–65.

84.

Denniston MM, Byrd KK, Klevens RM, Drobeniuc J, Kamili S, Jiles RB. An assessment of the performance of self-reported vaccination status for hepatitis B, National Health and nutrition examination survey 1999-2008. Am J Public Health. 2013;103(10):1865–73. https://doi.org/10.2105/AJPH.2013.301313.CrossRefPubMedPubMedCentral

85.

Loulergue P, Pulcini C, Massin S, Bernhard M, Fonteneau L, Levy-Bruhl D, et al. Validity of self-reported vaccination status among French healthcare students. Clin Microbiol Infect. 2014;20(12):O1152–4. https://doi.org/10.1111/1469-0691.12759.CrossRefPubMed

86.

World Health Organization. Hepatitis B (HepB3) immunization coverage among 1-year-olds (%) World Health Organization; 2020 [Available from: https://www.who.int/data/gho/data/indicators/indicator-details/GHO/hepatitis-b-(hepb3)-immunization-coverage-among-1-year-olds.

87.

Boyd A, Gozlan J, Carrat F, Rougier H, Girard PM, Lacombe K, et al. Self-reported patient history to assess hepatitis B virus serological status during a large screening campaign. Epidemiol Infect. 2019:147-e16.

88.

Kuo I, Mudrick DW, Strathdee SA, Thomas DL, Sherman SG. Poor validity of self-reported hepatitis B virus infection and vaccination status among young drug users. Clin Infect Dis. 2004;38(4):587–90. https://doi.org/10.1086/381440.CrossRefPubMed

89.

Topp L, Day C, Dore GJ, Maher L. Poor criterion validity of self-reported hepatitis B infection and vaccination status among injecting drug users: a review. Drug Alcohol Rev. 2009;28(6):669–75. https://doi.org/10.1111/j.1465-3362.2009.00060.x.CrossRefPubMed

90.

Lao TT. Long-term persistence of immunity after hepatitis B vaccination: is this substantiated by the literature? Hum Vaccin Immunother. 2017;13(4):918–20. https://doi.org/10.1080/21645515.2016.1267084.CrossRefPubMedPubMedCentral

91.

Romanò L, Galli C, Tagliacarne C, Tosti ME, Velati C, Fomiatti L, et al. Persistence of immunity 18-19 years after vaccination against hepatitis B in 2 cohorts of vaccinees primed as infants or as adolescents in Italy. Hum Vaccin Immunother. 2017;13(5):981–5. https://doi.org/10.1080/21645515.2017.1264795.CrossRefPubMedPubMedCentral

92.

Rieck T, Steffen A, Schmid-Küpke N, Feig M, Wichmann O, Siedler A. KV-Impfsurveillance: Ergänzungen zu den Impfdaten aus den Schuleingangsuntersuchungen. Epidemiol Bull. 2016;16:134.

93.

Santos-Hövener C, Lampert T. IMIRA - improving health monitoring in migrant populations: Robert Koch Institute; 2019. [Available from: https://www.rki.de/DE/Content/Gesundheitsmonitoring/Themen/Migration/IMIRA/imira_englisch.pdf?__blob=publicationFile

94.

Bundeszentrale für gesundheitliche Aufklärung (BZgA). Einstellungen, Wissen und Verhalten von Erwachsenen und Eltern gegenüber Impfungen – Ergebnisse der Repräsentativbefragung 2018 zum Infektionsschutz. Köln: Bundeszentrale für gesundheitliche Aufklärung; 2019. Available from: https://www.bzga.de/forschung/studien/abgeschlossene-studien/studien-ab-1997/impfen-und-hygiene/infektionsschutz-einstellungen-wissen-und-verhalten-von-erwachsenen-und-eltern-gegenueber-impfunge-1/.

95.

Walsh N, Verster A, Rodolph M, Akl EA. WHO guidance on the prevention of viral hepatitis B and C among people WHO inject drugs. Int J Drug Policy. 2014;25(3):363–71. https://doi.org/10.1016/j.drugpo.2014.01.009.CrossRefPubMed

96.

Weaver T, Metrebian N, Hellier J, Pilling S, Charles V, Little N, et al. Use of contingency management incentives to improve completion of hepatitis B vaccination in people undergoing treatment for heroin dependence: a cluster randomised trial. Lancet. 2014;384(9938):153–63. https://doi.org/10.1016/S0140-6736(14)60196-3.CrossRefPubMed

Title: Hepatitis B vaccination coverage in Germany: systematic review
Authors: Gyde Steffen
Ida Sperle
Thomas Harder
Navina Sarma
Sandra Beermann
Roma Thamm
Viviane Bremer
Ruth Zimmermann
Sandra Dudareva
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Hepatitis B
Vaccination
Published in: BMC Infectious Diseases / Issue 1/2021
Electronic ISSN: 1471-2334
DOI: https://doi.org/10.1186/s12879-021-06400-4

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Heart Failure Video

Year in Review: Heart failure and cardiomyopathies

Watch now

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits

STEP AAG HeroTeaserCollection image/© Tarek / Generated with AI / Stock.adobe.com, ACC 2024 Pediatric and Congenital Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Pulmonary Vascular Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Valvular Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 HF and Cardiomyopathies: Year in Review/© 2024 American College of Cardiology, Woman out walking/© Seventyfour / stock.adobe.com (symbolic image with model), Woman checking smartwatch /© saltdium / stock.adobe.com (symbolic image with model), Cardiac catheterization/© Damian / stock.adobe.com

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Objective

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2021

Sociodemographic characteristics and transmission risk factors in patients hospitalized for COVID-19 before and during the lockdown in France

Case report of an unusual hepatic abscess caused by Actinomyces odontolyticus in a patient with human immunodeficiency virus infection

Occurrence and multidrug resistance of Campylobacter spp. at duck farms and associated environmental and anthropogenic risk factors in Bangladesh

“PrEP’s just to secure you like insurance”: a qualitative study on HIV pre-exposure prophylaxis (PrEP) adherence and retention among black cisgender women in Mississippi

Multiple drug resistance of Campylobacter jejuni and Shigella isolated from diarrhoeic children at Kapsabet County referral hospital, Kenya

Measuring the uptake of continuous care among people living with HIV receiving antiretroviral therapy and social determinants of the uptake of continuous care in the southwest of China: a cross-sectional study

Highlights from the ACC 2024 Congress

ACC 2024 Congress Coverage