Impact of universal mass vaccination with monovalent inactivated hepatitis A vaccines - A systematic review

• Published in: Human vaccines & immunotherapeutics Vol. 13; no. 3; pp. 724 - 736
• Main Authors: Stuurman, Anke L., Marano, Cinzia, Bunge, Eveline M., De Moerlooze, Laurence, Shouval, Daniel
• Format: Journal Article
• Language: English
• Published: United States Taylor & Francis 04.03.2017; Taylor & Francis Group
• Subjects: Global Health; Hepatitis A - epidemiology; Hepatitis A - prevention & control; Hepatitis A Antibodies - blood; hepatitis A vaccine; Hepatitis A Vaccines - administration & dosage; Hepatitis A Vaccines - immunology; Humans; Immunoglobulin G - blood; Incidence; long-term persistence; Mass Vaccination; Review; systematic review; Treatment Outcome; universal vaccination; Vaccines, Inactivated - administration & dosage; Vaccines, Inactivated - immunology; hepatitis A vaccine; universal vaccination; systematic review; long-term persistence; incidence
• ISSN: 2164-5515; 2164-554X
• DOI: 10.1080/21645515.2016.1242539

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.