作者: Shen, Liping ; Wang, Fuzhen ; Zhang, Shuang ; Zhang, Guomin ; Li, Li ; Liang, Xiaofeng ; Cui, Fuqiang ; Bi, Shengli ; Sun, Xiaojin ; Feng, Zijian ; Wang, Huaqing ; Miao, Ning ; Zheng, Hui ; Rodewald, Lance E ; Jia, Zhiyuan ; Yin, Zundong ; Wang, Feng

Background and AimsChina has conducted surveillance for hepatitis A since 1990, and hepatitis A was highly‐to‐intermediately endemic in 1992 when a Chinese hepatitis A vaccine (HepA) was licensed and introduced as a family‐pay vaccine. In 2008, HepA was introduced into the Expanded Program on Immunization as a free childhood vaccine.Approach and ResultsThree nationally representative surveys conducted in 1992, 2006, and 2014 assessed hepatitis B serology. The 1992 survey included hepatitis A virus (HAV) serology, and we tested sera from the 2006 and 2014 surveys for HAV antibodies. We used surveillance, seroprevalence, and vaccination status data to describe the changing epidemiology of hepatitis A in China from 1990 through 2014. Before HepA licensure, anti‐HAV seroprevalence was 60% at 4 years of age, 70% at 10 years, and 90% at 59 years; incidence was 52/100,000 and peaked at 4 years. In 2006, after >10 years of private sector vaccination, HepA coverage was <30% among children <5 years, and incidence was 5.4/100,000 with a peak at 10 years. In 2014, coverage was >90% among children under 5 years; incidence was 1.9/100,000. Individuals born before the national introduction of HepA (1988‐2004) had lower anti‐HAV seroprevalence than earlier and later birth cohorts.ConclusionsThe incidence of hepatitis A declined markedly following HepA introduction and improvement of sanitation and hygiene. The emerging epidemiology is consistent with disease‐induced immunity having been replaced by vaccine‐induced immunity, resulting in a low incidence of hepatitis A. Catch‐up HepA campaigns to close the immunity gap among the 1998‐2004 birth cohorts should be considered.

2020-07-02·Human Vaccines & Immunotherapeutics

Hepatitis A vaccination

Article

作者: Zhang, Li

Hepatitis A is an important public health issue worldwide. Hepatitis A vaccine (HepA) was first licensed in 1992. Both inactivated HepA (HepA-I) and live attenuated HepA (HepA-L) are highly immunogenic and well tolerated, and immune protection postvaccination can persist for at least 20 y. HepA is effective for both preexposure and postexposure prophylaxis, especially among children and young adults. The strategy of HepA vaccination varies in different countries and mainly includes vaccination among high-risk populations, regional childhood vaccination and universal childhood vaccination. The incidence of hepatitis A has decreased greatly in many countries in the last 30 y, but hepatitis A outbreaks frequently occur among high-risk populations and those who have not been covered by universal child vaccination programs in recent years. Disease surveillance and serosurveys are suggested to clarify the shift in the epidemiology of hepatitis A. The long-term persistence of immune protection after one dose of HepA should be further studied, as well as the cost-effective evaluation of different strategies of HepA vaccination. Based on this evidence, the recommendation on HepA vaccination should be put forward scientifically and updated in a timely and well-implemented manner.

2019-10-01·Vaccine3区 · 医学

Uptake and safety of hepatitis A vaccination during pregnancy: A Vaccine Safety Datalink study

3区 · 医学

Article

作者: Irving, Stephanie A ; Getahun, Darios ; Naleway, Allison L ; Smith, Ning ; Daley, Matthew F ; Koppolu, Padma ; Donahue, James G ; Jackson, Lisa A ; Kharbanda, Elyse O ; Panagiotakopoulos, Lakshmi ; McCarthy, Natalie L ; Groom, Holly C ; Nordin, James D ; Vazquez-Benitez, Gabriela ; Klein, Nicola P

INTRODUCTIONInfection with hepatitis A virus (HAV) during pregnancy, although uncommon, is associated with gestational complications and pre-term labor. Hepatitis A vaccine (HepA) is recommended for anyone at increased risk for contracting hepatitis A, including women at risk who are also pregnant. Limited data are available on the safety of maternal HepA vaccination.OBJECTIVESAssess the frequency of maternal HepA receipt and evaluate the potential association between maternal vaccination and pre-specified maternal and infant safety outcomes.METHODSA retrospective cohort of pregnancies in the Vaccine Safety Datalink (VSD) resulting in live births from 2004 through 2015 was included. Pregnancies with HepA exposure were compared to those with other vaccine exposures, and to those with no vaccine exposures. Risk factors for contracting hepatitis A were identified up to one-year prior to or during the pregnancy using ICD-9 codes. Maternal and fetal adverse events were evaluated according to maternal HepA exposure status. Adjusted odds ratio (OR) were used to describe the association.RESULTSAmong 666,233 pregnancies in the study period, HepA was administered at a rate of 1.7 per 1000 (n = 1140), most commonly within the first six weeks of pregnancy. Less than 3% of those exposed to HepA during pregnancy had an ICD-confirmed risk factor. There were no significant associations between HepA exposure during pregnancy and gestational hypertension, gestational diabetes, pre-eclampsia/eclampsia, cesarean delivery, pre-term delivery, and low birthweight. There was a statistically significant association between HepA exposure during pregnancy and small-for-gestational age (SGA) infants (aOR 1.32, [95% CI 1.09, 1.60], p = 0.004).CONCLUSIONSThe rate of maternal HepA vaccination was low and rarely due to documented risk factors for vaccination. HepA vaccination during pregnancy was not associated with an increased risk for a range of adverse events examined among pregnancies resulting in live births, but an identified association between maternal HepA and SGA infant outcomes, while likely due to unmeasured confounding, warrants further exploration.

100 项与 Hepatitis A vaccine (Nothav) (GlaxoSmithKline) 相关的药物交易

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