National Center for Immunization and Respiratory Diseases, Atlanta, GA 30333, USA.
Pediatrics. 2012 Feb;129(2):213-21. doi: 10.1542/peds.2011-2197. Epub 2012 Jan 23.
Hepatitis A infection causes severe disease among adolescents and adults. The Advisory Committee on Immunization Practices instituted incremental recommendations for hepatitis A vaccination (HepA) at 2 years of age based on risk (1996), in selected states (1999), and universally at 1 year of age, with vaccination through 18 years of age based on risk or desire for protection (2006). We assessed adolescent HepA coverage in the United States and factors independently associated with vaccination.
Data from the 2009 National Immunization Survey-Teen (n = 20 066) were analyzed to determine ≥1- and ≥2-dose HepA coverage among adolescents 13 to 17 years of age. We used bivariate and multivariable analyses to test associations between HepA initiation and sociodemographic characteristics stratified by state groups: group 1, universal child vaccination since 1999; group 2, consideration for child vaccination since 1999; group 3, universal child vaccination at 1 year of age since 2006.
In 2009, national 1-dose HepA coverage among adolescents was 42.0%. Seventy percent of vaccinees completed the 2-dose series. One-dose coverage was 74.3% among group 1 states, 54.0% for group 2 states, and 27.8% for group 3 states. The adjusted prevalence ratios of vaccination initiation were highest for states with a vaccination requirement and for adolescents whose providers recommended HepA.
HepA coverage was low among most adolescents in the United States in 2009 leaving a large population susceptible to hepatitis A infection maturing into adulthood.
甲型肝炎感染可导致青少年和成年人罹患重病。免疫实践咨询委员会根据风险（1996 年）、在某些州（1999 年）以及普遍在 1 岁（基于风险或保护意愿，接种疫苗可延长至 18 岁）为甲型肝炎疫苗接种（HepA）制定了增量建议。我们评估了美国青少年甲型肝炎疫苗接种率以及与疫苗接种独立相关的因素。
对 2009 年全国青少年免疫接种调查（n=20066）的数据进行分析，以确定 13 至 17 岁青少年中至少接种 1 剂和至少接种 2 剂 HepA 的疫苗接种率。我们使用双变量和多变量分析来检验 HepA 接种起始与按州组分层的社会人口学特征之间的关联：组 1，自 1999 年以来普遍为儿童接种疫苗；组 2，自 1999 年以来考虑为儿童接种疫苗；组 3，自 2006 年以来，1 岁时普遍为儿童接种疫苗。
2009 年，美国青少年 1 剂 HepA 疫苗接种率为 42.0%。70%的疫苗接种者完成了 2 剂系列接种。在组 1 州，1 剂接种率为 74.3%，在组 2 州为 54.0%，在组 3 州为 27.8%。接种启动的调整后流行比率在有接种要求的州和提供者建议接种 HepA 的青少年中最高。
2009 年，美国大多数青少年的 HepA 疫苗接种率较低，使大量易感染甲型肝炎的人群在成年后仍易感染。
