Division of Viral Hepatitis, Clinical Interventions Team, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, United States.
Immunization Services Division, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention, United States.
Vaccine. 2018 Mar 14;36(12):1650-1659. doi: 10.1016/j.vaccine.2018.01.090. Epub 2018 Feb 12.
The hepatitis A (HepA) vaccine was recommended by the Advisory Committee on Immunization Practices (ACIP) incrementally from 1996 to 1999. In 2006, HepA vaccine was recommended (1) universally for children aged 12-23 months, (2) for persons who are at increased risk for infection, or (3) for any person wishing to obtain immunity. Catch-up vaccination can be considered.
To assess HepA vaccine coverage among adolescents and factors independently associated with vaccination administration in the US.
The 2008-2016 National Immunization Survey-Teen was utilized to determine 1 and ≥2 dose HepA vaccination coverage among adolescents aged 13-17 years. Factors associated with HepA vaccine series initiation (1 dose) were determined by bivariate and multivariable analyses. Data were stratified by state groups based on ACIP recommendation: universal child vaccination recommended since 1999 (group 1); child vaccination considered since 1999 (group 2); universal child vaccination recommendation since 2006 (group 3).
In 2016, national vaccination coverage for 1 and ≥2 doses of HepA vaccine among adolescents was 73.9% and 64.4%, respectively. Nationally, a 40 percentage point increase in vaccination coverage occurred among adolescents born in 1995 compared to adolescents born in 2003. Nationally, the independent factors associated with increased vaccine initiation was race/ethnicity (Hispanic, American Indian/Alaskan Native, Asian), military payment source and provider recommendation for HepA vaccination (2008-2013). Living in a suburban or rural region, living in poverty (level <1.33-5.03), and absence of state daycare or school HepA requirement were common factors associated with decreased likelihood of vaccine initiation.
Efforts to increase HepA vaccine coverage in adolescents in all regions of the country would strengthen population protection from hepatitis A virus (HAV).
甲型肝炎（HepA）疫苗于 1996 年至 1999 年期间被免疫实践咨询委员会（ACIP）逐步推荐使用。2006 年，HepA 疫苗被推荐（1）普遍用于 12-23 个月龄的儿童，（2）用于感染风险增加的人群，或（3）用于任何希望获得免疫力的人群。可以考虑补种疫苗。
评估美国青少年中 HepA 疫苗的接种情况，并确定与疫苗接种管理相关的独立因素。
利用 2008-2016 年国家免疫调查-青少年数据，确定 13-17 岁青少年中 1 剂和≥2 剂 HepA 疫苗接种覆盖率。通过双变量和多变量分析确定 HepA 疫苗接种系列启动（1 剂）的相关因素。根据 ACIP 建议，将数据按州组分层：自 1999 年以来推荐儿童普遍接种疫苗（第 1 组）；自 1999 年以来考虑儿童接种疫苗（第 2 组）；自 2006 年以来推荐儿童普遍接种疫苗（第 3 组）。
2016 年，美国青少年中 1 剂和≥2 剂 HepA 疫苗接种覆盖率分别为 73.9%和 64.4%。全国范围内，1995 年出生的青少年与 2003 年出生的青少年相比，疫苗接种率提高了 40 个百分点。全国范围内，与疫苗接种启动增加相关的独立因素是种族/民族（西班牙裔、美洲印第安人/阿拉斯加原住民、亚裔）、军事支付来源和提供者对 HepA 疫苗接种的建议（2008-2013 年）。生活在郊区或农村地区、生活贫困（收入水平<1.33-5.03）、州内日托或学校没有 HepA 接种要求，是疫苗接种启动可能性降低的常见因素。
在全国所有地区努力提高青少年中 HepA 疫苗的接种率，将加强人群对甲型肝炎病毒（HAV）的保护。
