Hepatitis B school-based vaccination programmes in the USA: a model for hepatitis A and B.
Following the recommendation for routine vaccination against hepatitis B virus for newborns, many states have started school-based catch-up vaccination of 11- to 12-year-olds. Implementation of these programmes requires educational and promotional initiatives to increase awareness among parents, children, teachers, school nurses, school boards and administration. Experience in Framingham, Massachusetts, suggests that over 90% of targeted hepatitis B vaccine coverage can be achieved. Because hepatitis B vaccination targeted at high-risk groups in the USA was largely unsuccessful, this suggests that the initial similar targeted approach with hepatitis A vaccination will also fail. Only about 50% of hepatitis A cases have a known risk factor, and multiple high-risk areas exist throughout the USA. However, the geographical clustering of these high-risk areas and the occurrence of periodic outbreaks, suggest that school-based hepatitis A vaccination programmes may be effective in reducing the risk of infection. A voluntary programme in San Antonio achieved 43% of the targeted coverage in its first year, and a compulsory programme is due to start in Oklahoma. The effectiveness of this programme is not yet known, but future recommendations are likely to include hepatitis A vaccination as a school entry requirement in areas with high incidence of hepatitis A.
Koff
R S
RS
University of Massachusetts Medical School, Department of Medicine, MetroWest Medical Center, 115 Lincoln Street, Framingham, MA, USA.
D002648:Child; D006506:Hepatitis A / Q000517:prevention & control; D022362:Hepatitis A Vaccines; D006509:Hepatitis B / Q000517:prevention & control*; D017325:Hepatitis B Vaccines / Q000494:pharmacology; D006801:Humans; D007231:Infant, Newborn; D009313:National Health Programs; D012307:Risk Factors; D012574:Schools; D014481:United States; D014611:Vaccination; D014761:Viral Hepatitis Vaccines / Q000494:pharmacology
D022362:Hepatitis A Vaccines; D017325:Hepatitis B Vaccines; D014761:Viral Hepatitis Vaccines