Allard R, Beauchemin J, Bédard L, Dion R, Tremblay M, Carsley J
Unité Maladies infectieuses, Direction de la santé publique de Montréal-Centre, Canada.
J Epidemiol Community Health. 2001 Apr;55(4):251-6. doi: 10.1136/jech.55.4.251.
To evaluate an intervention designed to curtail an outbreak of hepatitis A among gay men, especially the young and sexually active, by promoting their free vaccination.
The study analysed routine passive surveillance data, carried out questionnaire and serological surveys of vaccinees, and surveys among the target population in non-clinical venues.
15 000 free doses of hepatitis A vaccine were made available through clinics with large gay clienteles, or at gay events, and advertised by various means, in Montréal, Canada, from August 1996 to November 1997. Simultaneous vaccination against hepatitis B (always free for gay men) was also encouraged.
Information was obtained from persons with the disease during the epidemic period, a sample of men requesting vaccination, and five community samples of gay men.
The outbreak involved 376 gay men and the vaccine was distributed to approximately 10 000. Vaccinees were older than cases, but had many sex partners and comprised more food handlers. Special vaccination clinics at gay events were well attended but did not reach more high risk men than regular medical venues. A self reported vaccine coverage of 49% was achieved, but 26% of vaccinees already had anti-HAV antibodies. Disease incidence declined rapidly during the campaign.
The intervention nearly tripled self reported hepatitis A vaccine coverage but its late start precludes proving that it caused the subsequent drop in incidence. However, it also increased hepatitis B vaccination and it is believed it improved links between gay men, public health, clinicians and community groups.
通过推广免费接种疫苗，评估一项旨在遏制男同性恋者（尤其是年轻且有性活动的群体）甲型肝炎暴发的干预措施。
该研究分析了常规被动监测数据，对疫苗接种者进行了问卷调查和血清学调查，并在非临床场所对目标人群进行了调查。
1996年8月至1997年11月期间，在加拿大蒙特利尔，通过拥有大量男同性恋客户的诊所或在同性恋活动中提供了15000剂免费甲型肝炎疫苗，并通过多种方式进行宣传。同时也鼓励同时接种乙型肝炎疫苗（男同性恋者一直免费）。
从疫情期间的患者、申请接种疫苗的男性样本以及五个男同性恋社区样本中获取信息。
此次疫情涉及376名男同性恋者，疫苗分发了约10000人。接种疫苗者比病例年龄大，但性伴侣多，且食品处理人员更多。同性恋活动中的专门疫苗接种诊所就诊人数众多，但与常规医疗场所相比，接触到的高危男性并不更多。自我报告的疫苗接种覆盖率达到了49%，但26%的接种者已经有抗甲型肝炎病毒抗体。在活动期间疾病发病率迅速下降。
该干预措施使自我报告的甲型肝炎疫苗接种覆盖率几乎增加了两倍，但启动较晚，无法证明是其导致了随后发病率的下降。然而，它也增加了乙型肝炎疫苗接种，并且据信改善了男同性恋者、公共卫生、临床医生和社区团体之间的联系。
