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. 2017 Mar 4;13(3):724-736.
doi: 10.1080/21645515.2016.1242539. Epub 2016 Oct 27.

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

Anke L Stuurman  1 , Cinzia Marano  2 , Eveline M Bunge  1 , Laurence De Moerlooze  2 , Daniel Shouval  3
Affiliations

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

Anke L Stuurman et al. Hum Vaccin Immunother. .

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.

Keywords: hepatitis A vaccine; incidence; long-term persistence; systematic review; universal vaccination.

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