{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T17:18:40Z","timestamp":1777828720229,"version":"3.51.4"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2023,9,21]],"date-time":"2023-09-21T00:00:00Z","timestamp":1695254400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Center for HIV\/AIDS"},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,4,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Widespread outbreaks of person-to-person transmitted hepatitis A virus (HAV), particularly among people who inject drugs (PWID), continue across the United States and globally. However, the herd immunity threshold and vaccination coverage required to prevent outbreaks are unknown. We used surveillance data and dynamic modeling to estimate herd immunity thresholds among PWID in 16\u2005US states.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We used a previously published dynamic model of HAV transmission calibrated to surveillance data from outbreaks involving PWID in 16 states. Using state-level calibrated models, we estimated the basic reproduction number (R0) and herd immunity threshold for PWID in each state. We performed a meta-analysis of herd immunity thresholds to determine the critical vaccination coverage required to prevent most HAV outbreaks among PWID.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Estimates of R0 for HAV infection ranged from 2.2 (95% confidence interval [CI], 1.9\u20132.5) for North Carolina to 5.0 (95% CI, 4.5\u20135.6) for West Virginia. Corresponding herd immunity thresholds ranged from 55% (95% CI, 47%\u201361%) for North Carolina to 80% (95% CI, 78%\u201382%) for West Virginia. Based on the meta-analysis, we estimated a pooled herd immunity threshold of 64% (95% CI, 61%\u201368%; 90% prediction interval, 52%\u201376%) among PWID. Using the prediction interval upper bound (76%) and assuming 95% vaccine efficacy, we estimated that vaccination coverage of 80% could prevent most HAV outbreaks.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Hepatitis A vaccination programs in the United States may need to achieve vaccination coverage of at least 80% among PWID in order to prevent most HAV outbreaks among this population.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciad552","type":"journal-article","created":{"date-parts":[[2023,9,22]],"date-time":"2023-09-22T20:26:26Z","timestamp":1695414386000},"page":"976-982","source":"Crossref","is-referenced-by-count":7,"title":["Determining Herd Immunity Thresholds for Hepatitis A Virus Transmission to Inform Vaccination Strategies Among People Who Inject Drugs in 16\u2005US States"],"prefix":"10.1093","volume":"78","author":[{"given":"Judy","family":"Yang","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases and Global Public Health, University of California\u2013San Diego , La Jolla, California , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathan C","family":"Lo","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University , Stanford, California , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emmanuelle A","family":"Dankwa","sequence":"additional","affiliation":[{"name":"Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T. H. Chan School of Public Health , Boston, Massachusetts , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christl A","family":"Donnelly","sequence":"additional","affiliation":[{"name":"Department of Statistics, University of Oxford , Oxford , United Kingdom"},{"name":"Medical Research Council Centre for Global Infectious Disease Analysis, Imperial College London , London , United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ribhav","family":"Gupta","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University , Stanford, California , USA"},{"name":"University of Minnesota Medical School , Minneapolis, Minnesota , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martha P","family":"Montgomery","sequence":"additional","affiliation":[{"name":"Division of Viral Hepatitis, US Centers for Disease Control and Prevention , Atlanta, Georgia , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark K","family":"Weng","sequence":"additional","affiliation":[{"name":"Division of Viral Hepatitis, US Centers for Disease Control and Prevention , Atlanta, Georgia , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natasha K","family":"Martin","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Global Public Health, University of California\u2013San Diego , La Jolla, California , USA"},{"name":"Population Health Sciences, University of Bristol , Bristol , United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,9,21]]},"reference":[{"key":"2024041017081267700_ciad552-B1","author":"Centers for Disease Control and Prevention"},{"key":"2024041017081267700_ciad552-B2","doi-asserted-by":"crossref","first-page":"413","DOI":"10.15585\/mmwr.mm6818a2","article-title":"Increase in hepatitis A virus 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