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

Human Vaccines & Immunotherapeutics (formerly Human Vaccines)
Volume 13, Issue 3, 2017
http://www.tandfonline.com/toc/khvi20/current

Review
Impact of universal mass vaccination with monovalent inactivated hepatitis A vaccines – A systematic review
Anke L. Stuurman, Cinzia Marano, Eveline M. Bunge, Laurence De Moerlooze & Daniel Shouval
Pages: 724-736
Published online: 27 Oct 2016
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.