Impact of universal mass vaccination with monovalent inactivated hepatitis A vaccines – A systematic review. Issue 3 (4th March 2017)

• Record Type: Journal Article
• Authors: Stuurman, Anke L.; Marano, Cinzia; Bunge, Eveline M.; De Moerlooze, Laurence; Shouval, Daniel
• Is Part Of: Human vaccines & immunotherapeutics. Volume 13:Issue 3(2017)
• Page Start: 724
• Page End: 736
• Publication Date: 2017-03-04
• Subjects: hepatitis A vaccine -- incidence -- long-term persistence -- systematic review -- universal vaccination; Vaccines -- Periodicals; 615.372
• DOI: 10.1080/21645515.2016.1242539
• Languages: English
• ISSNs: 2164-5515

Abstract

ABSTRACT: The WHO recommends integration of universal mass vaccination (UMV) against hepatitis A virus (HAV) in national immunization schedules for children aged ≥1 year, if justified on the basis of acute HAV incidence, declining endemicity from high to intermediate and cost-effectiveness. This recommendation has been implemented in several countries. Our aim was to assess the impact of UMV using monovalent inactivated hepatitis A vaccines on incidence and persistence of anti-HAV (IgG) antibodies in pediatric populations. We conducted a systematic review of literature published between 2000 and 2015 in PubMed, Cochrane Library, LILACS, IBECS identifying a total of 27 studies (Argentina, Belgium, China, Greece, Israel, Panama, the United States and Uruguay). All except one study showed a marked decline in the incidence of hepatitis A post introduction of UMV. The incidence in non-vaccinated age groups decreased as well, suggesting herd immunity but also rising susceptibility. Long-term anti-HAV antibody persistence was documented up to 17 y after a 2-dose primary vaccination. In conclusion, introduction of UMV in countries with intermediate endemicity for HAV infection led to a considerable decrease in the incidence of hepatitis A in vaccinated and in non-vaccinated age groups alike.