Zhang Li
Academy of Preventive Medicine, Shandong University , Jinan, China.
Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention , Jinan, China.
Hum Vaccin Immunother. 2020 Jul 2;16(7):1565-1573. doi: 10.1080/21645515.2020.1769389. Epub 2020 Jul 10.
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.
甲型肝炎是一个全球性的重要公共卫生问题。甲型肝炎疫苗(HepA)于1992年首次获得许可。灭活甲型肝炎疫苗(HepA-I)和减毒活甲型肝炎疫苗(HepA-L)均具有高度免疫原性且耐受性良好,接种疫苗后的免疫保护作用可持续至少20年。HepA对暴露前和暴露后预防均有效,尤其是在儿童和年轻人中。HepA疫苗接种策略在不同国家有所不同,主要包括高危人群接种、区域性儿童接种和全民儿童接种。在过去30年中,许多国家的甲型肝炎发病率大幅下降,但近年来,甲型肝炎疫情仍频繁发生在高危人群以及未纳入全民儿童疫苗接种计划的人群中。建议开展疾病监测和血清学调查,以明确甲型肝炎流行病学的变化。应进一步研究一剂HepA后免疫保护的长期持续性,以及不同HepA疫苗接种策略的成本效益评估。基于这些证据,应科学地提出HepA疫苗接种建议,并及时、妥善地进行更新。