One or two doses of hepatitis A vaccine in universal vaccination programs in children in 2020: A systematic review. Issue 2 (21st January 2022)

• Record Type: Journal Article
• Authors: Andani, Anar; van Damme, Pierre; Bunge, Eveline M.; Salgado, Fernanda; van Hoorn, Rosa C.; Hoet, Bernard
• Is Part Of: Vaccine. Volume 40:Issue 2(2022)
• Page Start: 196
• Page End: 205
• Publication Date: 2022-01-21
• Subjects: Non-live hepatitis A vaccine -- Pediatric immunization schedule -- Incidence -- Antibody persistence -- Systematic review; GMC geometric mean concentration -- HAV hepatitis A virus -- IU international units -- NIP national immunization program -- NITAG National Immunization Technical Advisory Groups -- PAHO Pan-American Health Organization -- UV universal vaccination -- US United States -- WHO World Health Organization; Vaccines -- Periodicals; 615.372
• DOI: 10.1016/j.vaccine.2021.01.038
• Languages: English
• ISSNs: 0264-410X

Abstract

Graphical abstract: Highlights: Systematic review of the impact of two- and one-dose non-live hepatitis A virus vaccination programs in children. two- and one-dose programs induced rapid declines in incidence of hepatitis A in all age groups. two-dose programs induced declines in incidence of hepatitis A for ≥14 years. Effects of one-dose programs on incidence of hepatitis A are unknown beyond 6 years. Antibody persistence was followed-up and documented for ≥15 and ≥10 years after 2 and one vaccine doses. Abstract: Background: Hepatitis A virus (HAV) is a global health concern as outbreaks continue to occur. Since 1999, several countries have introduced universal vaccination (UV) of children against HAV according to approved two-dose schedules. Other countries have implemented one-dose UV programs since 2005; the long-term impact of this schedule is not yet known. Methods: We conducted a systematic literature search in four electronic databases for data published between January 2000 and July 2019 to assess evidence for one-dose and two-dose UV of children with non-live HAV vaccines and describe their global impact on incidence, mortality, and severity of hepatitis A, vaccine effectiveness, vaccine efficacy, and antibody persistence. Results: Of 3739 records screened, 33 peer-reviewed articles and one conference abstract were included. Rapid declines in incidence of hepatitis A and related outcomes were observed in all age groups post-introduction of UV programs, which persisted for at least 14 years for two-dose and six years for one-dose programs according to respective study durations. Vaccine effectiveness was ≥95% over 3–5 years for two-dose programs. Vaccine efficacy was >98% over 0.1–7.5 years for one-dose vaccination. Antibody persistence in vaccinated individuals was documented for up to 15 years (≥90%) and ten years (≥74%) for two-dose and one-dose schedules, respectively. Conclusion: Experience with two-dose UV of children against HAV is extensive, demonstrating an impact on the incidence of hepatitis A and antibody persistence for at least 15 years in many countries globally. Because evidence is more limited for one-dose UV, we were unable to draw conclusions on immune response persistence beyond ten years or the need for booster doses later in life. Ongoing epidemiological monitoring is essential in countries implementing one-dose UV against HAV. Based on current evidence, two doses of non-live HAV vaccines are needed to ensure long-term protection.