Hepatitis B: are at-risk individuals vaccinated if screened and found negative for HBV? Results of an online survey conducted in six EU countries.

INTRODUCTION: Vaccination is the best way to prevent hepatitis B infection and its consequences. The aim of the present study is to analyze the current vaccination practices within various population subgroups who are offered screening for hepatitis B, when found negative, in Germany, Hungary, Italy, the Netherlands, Spain and the UK. METHODS: Online surveys were conducted in the six countries. In total, 1181 experts from six different health professions were invited to participate. Descriptive analyses of data were performed. RESULTS: Less than half of the respondents in the Netherlands, only about 1/4 in Germany and none in Hungary reported that the vaccine is commonly offered to people who inject drugs. Less than half of the respondents in Germany reported vaccinating sex workers or HIV positive patients against hepatitis B as common practice. None in Hungary stated that vaccinating sex workers is common practice, and only according to a minority (17%) HIV patients are commonly vaccinated. 1/4 to 1/3 of respondents in Germany, the Netherlands, Italy, Hungary and the UK, indicated that HCV positive patients are only sporadically immunized. Only in Spain almost half of the respondents reported that migrants from hepatitis B endemic areas who are screened negative are commonly vaccinated. Widespread uncertainty about vaccination practices for asylum seekers was reported. CONCLUSIONS: By showing the gaps between current practices and policies in place, our findings can help to increase the success of future vaccination programmes. Implementation of training for health care professional, e.g. introducing vaccinology and vaccination policy courses in the medical and paramedical curriculum, could contribute to a more homogenous application of the recommendations regarding immunization against hepatitis B. Our results show, nonetheless, that the universal vaccination approach, coupled with targeted programmes for immigrants, represents the only way to make the elimination of hepatitis B a foreseeable, realistic objective.