Hepatitis A vaccines : impact of universal childhood vaccination programmes
Faculty of Medicine and Health Sciences
European gastroenterology and hepatology review
, p. 77-83
University of Antwerp
Hepatitis A remains one of the most common infectious diseases that can be prevented by vaccination. Vaccines against the hepatitis A virus (HAV) infection are highly immunogenic, have an excellent safety profile and induce long-lasting immunity, but are still under-used. Improvements in living standards drive a worldwide decrease in disease incidence and cause an epidemiological shift, thus generating large populations of susceptible people. Susceptible people living in or visiting geographic areas with intermediate endemicity in transition are therefore at an increased risk of infection. Immunisation policies that are based only on targeting high-risk groups and/or offering post-exposure prophylaxis are insufficient to control infection at the population level, whereas increasing evidence indicates that universal childhood immunisation is an effective alternative option. Programmes ranging from field trials and regional immunisation projects to nationwide immunisations have demonstrated the success of this strategy in reducing disease incidence, not only in the vaccinated population but also in the wider community through herd immunity. Universal childhood immunisation can be cost-effective in countries with intermediate endemicity as well as in geographic regions of mixed high and intermediate socioeconomic status, and therefore represents a strategy worth considering for controlling the incidence of hepatitis A disease.