title: Impact of universal mass vaccination with monovalent inactivated hepatitis A vaccines - A systematic review.
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.
authors: a Pallas, Health Research and Consultancy BV , Rotterdam , The Netherlands.
authors: Anke L
authors: AL
authors: Stuurman
authors: b GSK Vaccines , Wavre , Belgium.
authors: Cinzia
authors: C
authors: Marano
authors: a Pallas, Health Research and Consultancy BV , Rotterdam , The Netherlands.
authors: Eveline M
authors: EM
authors: Bunge
authors: b GSK Vaccines , Wavre , Belgium.
authors: Laurence
authors: L
authors: De Moerlooze
authors: c Hadassah Hebrew University Hospital , Liver Unit , Jerusalem , Israel.
authors: Daniel
authors: D
authors: Shouval
mesh_terms: D014943:Global Health; D006506:Hepatitis A / Q000453:epidemiology* / Q000517:prevention & control*; D035922:Hepatitis A Antibodies / Q000097:blood; D022362:Hepatitis A Vaccines / Q000008:administration & dosage* / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D015994:Incidence; D032541:Mass Vaccination; D016896:Treatment Outcome; D015164:Vaccines, Inactivated / Q000008:administration & dosage / Q000276:immunology
chemical_list: D035922:Hepatitis A Antibodies; D022362:Hepatitis A Vaccines; D007074:Immunoglobulin G; D015164:Vaccines, Inactivated
keywords: hepatitis A vaccine; incidence; long-term persistence; systematic review; universal vaccination