Premium
Effectiveness of universal hepatitis A immunization of children in Minsk City, Belarus: four‐year follow‐up
Author(s) -
Fisenka E. G.,
Germanovich F. A.,
Glinskaya I. N.,
Lyabis O. I.,
Rasuli A. M.
Publication year - 2008
Publication title -
journal of viral hepatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 100
eISSN - 1365-2893
pISSN - 1352-0504
DOI - 10.1111/j.1365-2893.2008.01031.x
Subject(s) - medicine , vaccination , incidence (geometry) , hepatitis a vaccine , hepatitis a , immunization , pediatrics , hepatitis , hepatitis b , immunology , antibody , physics , optics
Summary. Hepatitis A is a reportable disease in Belarus. Universal hepatitis A vaccination of children aged 6 years in Minsk City began in 2003. This analysis was conducted to evaluate the short‐term impact of the program. Hepatitis A incidence data from 1954 to 2006 was compiled. Vaccination effectiveness was estimated by comparing the incidence of reported hepatitis A cases after 4 years of immunization (2006) with the incidence when the vaccination program started (2003). The vaccines used were Avaxim 160 ™ or Avaxim 80 ™ (95%) and Havrix 720 ™ (5%). From 2003 through 2006, hepatitis A incidence in vaccinated children under 14 years was 20‐fold lower than the incidence in unvaccinated children (0.3 cases/10000 vs 5.98/10000; odds ratio = 0.05, 95% CI: 0.012–0.202), for a vaccination effectiveness of 95%. The decreased incidence of hepatitis A in all age groups in 2006 (by 12 times in preschool children aged 1–5 years, 13 times in children aged 10–14 years and 4–6 times among adults), including those without high coverage by vaccination, suggest a herd effect. Routine vaccination also resulted in a shift of the age pattern of hepatitis A morbidity. The proportion of cases in children under 14 years decreased from 33% to 41% in 2000–2002 to 7% in 2005–2006. We conclude that introduction of universal hepatitis A vaccination in Minsk resulted in sharply reduced incidence in both vaccinated and unvaccinated children. Hepatitis A virus circulation might decrease further by beginning vaccination at a younger age.