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. 2023 Jun 16;13(1):9762.
doi: 10.1038/s41598-023-36739-4.

Hepatitis A seroprevalence, vaccination status and demographic determinants in children and adolescents in Germany, 2014-2017, a population-based study

Julia Enkelmann  1 , Ronny Kuhnert  2 , Klaus Stark  3 , Mirko Faber  3
Affiliations

Hepatitis A seroprevalence, vaccination status and demographic determinants in children and adolescents in Germany, 2014-2017, a population-based study

Julia Enkelmann et al. Sci Rep. .

Abstract

Children play an important role in hepatitis A virus (HAV) transmission but, due to frequent asymptomatic or mild courses, these infections are underrecognized in routine surveillance. Here, we analyzed hepatitis A (HA) seroprevalence, vaccination status and demographic determinants and estimated previous HAV infections in a cross-sectional population-based study of children and adolescents with residence in Germany 2014-2017, performing weighted univariable and multivariable logistic regression. Of 3567 participants aged 3-17 years, serological results were available for 3013 (84.5%), vaccination records for 3214 (90.1%) and both for 2721 (76.3%). Of 2721 with complete results, 467 (17.2%) were seropositive, thereof 412 (15.1%) with and 55 (2.0%) without previous HA vaccination, indicating previous HAV infection. Seropositivity was associated with age, residence in Eastern states, high socioeconomic status and migration background with personal migration experience. Participants with migration background and personal migration experience also had the highest odds ratios for previous HAV infection. Germany remains a country with very low HA endemicity. The current vaccination recommendations focusing on individuals with a high risk for HAV exposure (e.g. travelers to endemic countries) or severe disease appear appropriate. Migration and travel patterns as well as the endemicity in other countries influence the domestic situation, warranting further monitoring.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Flow chart of KiGGS 2 study: study participants, number of participants providing serum samples for HAV testing, HA vaccination records and anti-HAV-IgG-antibody prevalence according to HA vaccination status. *Anti-HAV-IgG-antibodies, **Received ≥ 1 dose of HA vaccine. Dark grey = excluded; light grey = additional information available in the referenced tables.
Figure 2
Figure 2
Estimated anti-HAV IgG prevalence by age, KiGGS study wave 2, Germany 2014–2017 (n = 3013). Error bars indicate 95% CI. The dashed line depicts the mean weighted seroprevalence overall (12.83%).
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