The need for an evidence-based decision-making process with regard to control of hepatitis A.
Universal hepatitis A (HA) vaccination was implemented by the Argentinean Ministry of Health in June 2005 with a single dose at age 12 months. The decision was made taking into account the following factors. (1) Disease burden: The incidence rate for the disease increased from 2003 to 2004; the northern and western regions of the country were the most affected. Sero-prevalence data for children 1-15 years old was 54% for the whole country, with differences per region and age. From May 1982 to September 2002, 210 patients were recruited with acute hepatic failure; HA was the aetiology in 61% of them. (2) Cost-effectiveness: Compared with no vaccination, the one-dose schedule would save US$15.3 millions, with regional variations. (3) Vaccine features: Immunization with one-dose schedule HA vaccine confers good immunogenicity and effectiveness. (4) Programmatic feasibility: The National Immunizations Program has appropriate distribution system for vaccines, with adequate cold chain. (5) Social acceptance and political compromise: The population largely accepts HA vaccination and the national authorities should be committed to providing it regularly. The main global issue is that hepatitis A virus infection remains the most commonly reported vaccine-preventable disease in many parts of the world despite the availability of vaccines.
Gentile
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Epidemiology Department, Hospital de Niños Ricardo Gutierrez, Buenos Aires, Argentina. angelagentile@fibertel.com.ar
D003657:Decision Making; D055317:Evidence-Based Practice; D006506:Hepatitis A / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D022362:Hepatitis A Vaccines / Q000191:economics / Q000276:immunology; D006801:Humans; D017589:Immunization Programs / Q000191:economics; D007115:Immunization Schedule; D007223:Infant; D007843:Latin America; D015995:Prevalence
D022362:Hepatitis A Vaccines