Effect of hepatitis A vaccination programs for migrant children on the incidence of hepatitis A in The Netherlands.

BACKGROUND Since 1998 Municipal Public Health Services (MPHSs) in The Netherlands carried out Hepatitis A (HAV) vaccination programs for Turkish and Moroccan children to reduce import and secondary HAV infections. The aim of this study was to assess the effects of the programs on HAV incidence. METHODS MPHSs were questioned about HAV vaccination programs for migrant children. Notification data of HAV over the period 1995-2006 were analysed. RESULTS Since 1998, 19 MPHSs (58%) organized vaccination programs for Turkish and Moroccan children. A large variation in the range of activities in HAV vaccination programs was observed. In The Netherlands, HAV incidence declined, from 6.5 per 100,000 inhabitants in 1995 to 1.3 in 2005. HAV incidence in children of Turkish and Moroccan decent declined from 70.3 per 100,000 in 2000 to 13.5 per 100,000 in 2005. Regions where MPHSs organized vaccination campaigns had the steepest decline in HAV incidence. CONCLUSION The decline in HAV incidence in The Netherlands coincided with that observed for the rest of Europe. Therefore, also other causes than the enhanced vaccination programs could have contributed to this effect. At present, low priority is placed on continuing these HAV vaccination programs, as in areas without enhanced programs the incidence also declined to very low levels. Because HAV is still endemic in Morocco and Turkey, it remains important that all travellers to these countries are vaccinated against HAV, regardless of their country of origin.