The value of immunization against hepatitis A.
Safe and effective inactivated vaccines should soon be available for prevention of hepatitis A virus infections in the United States. Here we review the heterogeneous distribution of hepatitis A cases among different risk groups, age groups, and geographic regions of the United States and comment on several possible strategies for using hepatitis A vaccines in immunization programs. We conclude that immunization targeted exclusively at groups that are at high risk of developing hepatitis A is unlikely to significantly lower national rates of the disease. While universal immunization of young children may accomplish this goal, such a practice is likely to prove unacceptably costly. Alternative strategies worthy of consideration include immunization targeted to specific risk groups on a regional basis, based on knowledge of the local epidemiology of hepatitis A.
Lemon
S M
SM
Department of Medicine, University of North Carolina at Chapel Hill 27599-7030.
Shapiro
C N
CN
D002648:Child; D003906:Developing Countries; D006506:Hepatitis A / Q000453:epidemiology / Q000517:prevention & control*; D022362:Hepatitis A Vaccines; D006507:Hepatovirus / Q000276:immunology*; D006801:Humans; D017589:Immunization Programs; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D014611:Vaccination; D015164:Vaccines, Inactivated; D014761:Viral Hepatitis Vaccines
D022362:Hepatitis A Vaccines; D015164:Vaccines, Inactivated; D014761:Viral Hepatitis Vaccines