{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T23:03:36Z","timestamp":1778627016118,"version":"3.51.4"},"reference-count":45,"publisher":"Cambridge University Press (CUP)","issue":"7","license":[{"start":{"date-parts":[[2015,11,13]],"date-time":"2015-11-13T00:00:00Z","timestamp":1447372800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["journals.cambridge.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2016,5]]},"abstract":"<jats:title>SUMMARY<\/jats:title><jats:p>Several outbreaks of hepatitis A in men who have sex with men (MSM) were reported in the 1980s and 1990s in Australia and other countries. An effective hepatitis A virus (HAV) vaccine has been available in Australia since 1994 and is recommended for high-risk groups including MSM. No outbreaks of hepatitis A in Australian MSM have been reported since 1996. In this study, we aimed to estimate HAV transmissibility in MSM populations in order to inform targets for vaccine coverage in such populations. We used mathematical models of HAV transmission in a MSM population to estimate the basic reproduction number (<jats:italic>R<\/jats:italic><jats:sub>0<\/jats:sub>) and the probability of an HAV epidemic occurring as a function of the immune proportion. We estimated a plausible range for<jats:italic>R<\/jats:italic><jats:sub>0<\/jats:sub>of 1\u00b771\u20133\u00b767 for HAV in MSM and that sustained epidemics cannot occur once the proportion immune to HAV is greater than ~70%. To our knowledge this is the first estimate of<jats:italic>R<\/jats:italic><jats:sub>0<\/jats:sub>and the critical population immunity threshold for HAV transmission in MSM. As HAV is no longer endemic in Australia or in most other developed countries, vaccination is the only means of maintaining population immunity &gt;70%. Our findings provide impetus to promote HAV vaccination in high-risk groups such as MSM.<\/jats:p>","DOI":"10.1017\/s0950268815002605","type":"journal-article","created":{"date-parts":[[2015,11,13]],"date-time":"2015-11-13T10:35:50Z","timestamp":1447410950000},"page":"1528-1537","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":63,"title":["Estimating the critical immunity threshold for preventing hepatitis A outbreaks in men who have sex with men"],"prefix":"10.1017","volume":"144","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2893-0969","authenticated-orcid":false,"given":"D. G.","family":"REGAN","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. 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The Australian Immunisation Handbook, 10th edn, 2013 (http:\/\/www.health.gov.au\/internet\/immunise\/publishing.nsf\/Content\/handbook10-4-4). Accessed 26 March 2015."},{"key":"S0950268815002605_ref30","doi-asserted-by":"publisher","DOI":"10.1002\/0471721182"},{"key":"S0950268815002605_ref13","first-page":"E291","article-title":"Immunisation Coverage Annual Report, 2011","volume":"37","author":"Hull","year":"2013","journal-title":"Communicable Diseases Intelligence"},{"key":"S0950268815002605_ref4","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268898001563"},{"key":"S0950268815002605_ref38","doi-asserted-by":"publisher","DOI":"10.1111\/1467-9876.00233"},{"key":"S0950268815002605_ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2013.08.002"},{"key":"S0950268815002605_ref7","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.302.6789.1399-a"},{"key":"S0950268815002605_ref17","unstructured":"Stokes M-L . An outbreak of hepatitis A among homosexual men in Eastern Sydney, 1991\u20131992 (Master's Thesis). University of New South Wales, 1994."},{"key":"S0950268815002605_ref18","first-page":"550","volume-title":"Fields Virology","author":"Hollinger","year":"1990"},{"key":"S0950268815002605_ref22","first-page":"409","article-title":"Epidemiological model of hepatitis A","volume":"95","author":"Delimar","year":"1993","journal-title":"Periodicum Biologorum"},{"key":"S0950268815002605_ref25","doi-asserted-by":"publisher","DOI":"10.1086\/505115"},{"key":"S0950268815002605_ref26","doi-asserted-by":"publisher","DOI":"10.1002\/cld.253"},{"key":"S0950268815002605_ref24","doi-asserted-by":"publisher","DOI":"10.1111\/j.1423-0410.1994.tb01293.x"},{"key":"S0950268815002605_ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2006.11.020"},{"key":"S0950268815002605_ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2012.03.024"},{"key":"S0950268815002605_ref27","doi-asserted-by":"publisher","DOI":"10.1002\/hep.21052"},{"key":"S0950268815002605_ref35","unstructured":"STIs in Gay Men Action Group (STIGMA). Australian sexually transmitted infection & HIV testing guidelines 2014 for asymptomatic men who have sex with men (http:\/\/stipu.nsw.gov.au\/stigma\/sti-testing-guidelines-for-msm\/). Accessed 4 September 2015."},{"key":"S0950268815002605_ref42","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-842X.2003.tb00803.x"},{"key":"S0950268815002605_ref16","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2015.01.090"},{"key":"S0950268815002605_ref19","volume-title":"An Introduction to Infectious Disease Modelling","author":"Vynnycky","year":"2010"},{"key":"S0950268815002605_ref39","unstructured":"Hens N . Inferring reproductive numbers from the final size epidemic data on hepatitis A in Flanders, Belgium: truncation, censoring and heterogeneity, 2011 (http:\/\/www2.warwick.ac.uk\/fac\/sci\/statistics\/crism\/workshops\/infer\/talks\/hens_et_al_infer_2011.pdf). Accessed 26 March 2015."},{"key":"S0950268815002605_ref44","unstructured":"Australasian Sexual Health Alliance (ASHA). Australian STI management guidelines for use in primary care (http:\/\/www.sti.guidelines.org.au\/resources\/filter\/item\/hepatitis-a-2). 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