Chodick Gabriel, Green Manfred S, Heymann Anthony D, Rosenmann Lena, Shalev Varda
Medical Informatics Department, Maccabi Healthcare Services, Tel Aviv, Israel.
Prev Med. 2007 Nov;45(5):386-91. doi: 10.1016/j.ypmed.2007.05.011. Epub 2007 May 21.
In 1999 Israel became the first country to introduce immunization against hepatitis A to its national childhood vaccination program. The study objectives were to assess the uptake of hepatitis A vaccine following the new policy and to examine the incidence of hepatitis A and the number of prevented cases.
Data on incidence of hepatitis A and vaccination rates were obtained from a large health maintenance organization in Israel covering 1.6 million members. We identified all members that were diagnosed by a primary care physician as suffering from hepatitis A, had a positive hepatitis A virus-IgM test result, or were hospitalized due to hepatitis A between 1998 and 2004.
The results indicate that 5 years following its inclusion in the national childhood immunization program, vaccination coverage levels with at least one dose of hepatitis A vaccine for children aged under 5 years and 5-14 years were 87% and 51%, respectively. During this period the annual incidence rates declined by 88% from 142.4 to 17.3 per 100,000. The most significant reduction in morbidity was observed among children.
In endemic areas, vaccination of infants and children against hepatitis A may be efficient to greatly reduce the total burden of the disease.
1999年，以色列成为首个将甲型肝炎免疫接种纳入其国家儿童疫苗接种计划的国家。本研究的目的是评估新政策实施后甲型肝炎疫苗的接种情况，并调查甲型肝炎的发病率以及预防病例数。
甲型肝炎发病率和疫苗接种率的数据来自以色列一家大型健康维护组织，该组织覆盖160万名成员。我们确定了在1998年至2004年期间，所有被初级保健医生诊断为患有甲型肝炎、甲型肝炎病毒IgM检测结果呈阳性或因甲型肝炎住院的成员。
结果表明，在纳入国家儿童免疫计划5年后，5岁以下和5至14岁儿童至少接种一剂甲型肝炎疫苗的覆盖率分别为87%和51%。在此期间，年发病率从每10万人142.4例下降到17.3例，降幅为88%。发病率下降最显著的是儿童。
在流行地区，为婴幼儿接种甲型肝炎疫苗可能有效地大幅减轻该病的总体负担。
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