Mikhailov Mikhail I, Lopatukhina Maria A, Asadi Mobarhan Fedor A, Ilchenko Lyudmila Yu, Kozhanova Tatyana V, Isaeva Olga V, Karlsen Anastasiya A, Potemkin Ilya A, Kichatova Vera S, Saryglar Anna A, Oorzhak Natalia D, Kyuregyan Karen K
Department of Viral Hepatitis, Russian Medical Academy of Continuous Professional Education, 125993 Moscow, Russia.
Laboratory of Viral Hepatitis, Mechnikov Research Institute for Vaccines and Sera, 105064 Moscow, Russia.
Vaccines (Basel). 2020 Dec 20;8(4):780. doi: 10.3390/vaccines8040780.
Since August 2012, universal single-dose vaccination in children aged at least three years has been implemented in the Republic of Tuva, which was previously the region most affected by hepatitis A in Russia. The objective of this cross-sectional study was the assessment of the immunological and epidemiological effectiveness of vaccination program five years following its implementation. In the pre-vaccination period, anti-HAV antibody detection rates in Tuva was 66.0% [95% CI: 56.3-74.6%] in children aged 10-14 years and reached a plateau (>95%) by age 20-29 years. Annual incidence rates in children under 18 years of age peaked at 450-860 per 100,000 in pre-vaccination years but dropped to 7.5 per 100,000 in this age group and to 3.2 per 100,000 in the total population one year after the start of vaccination. Since 2016, no cases of hepatitis A has been reported in Tuva. Serum anti-HAV antibodies were quantified in samples from healthy children following single-dose vaccination. Protective anti-HAV antibody concentrations (≥10 mIU/mL) were detected in 98.0% (95% CI: 96.2-99.0% (442/451)) of children tested one month after single-dose immunization, in 93.5% (95% CI: 91.0-95.4% (477/510)) and in 91.1% (95% CI: 88.2-93.4% (422/463)) of children one year and five years after single-dose immunization, respectively. Anti-HAV antibody geometric mean concentrations were similar in sera collected one month, one year, and five years following single-dose vaccination: 40.24 mIU/mL, 44.96 mIU/mL, and 57.73 mIU/mL, respectively ( > 0.05). These data confirm that single-dose vaccination is an effective method of bringing hepatitis A under control in a short period of time in a highly endemic region.
自2012年8月起，图瓦共和国对至少3岁的儿童实施了普遍的单剂量疫苗接种，该地区此前是俄罗斯甲型肝炎感染最严重的地区。这项横断面研究的目的是评估疫苗接种计划实施五年后的免疫和流行病学效果。在疫苗接种前的时期，图瓦10至14岁儿童的抗甲型肝炎病毒（HAV）抗体检测率为66.0%[95%置信区间：56.3 - 74.6%]，到20至29岁时达到平台期（>95%）。18岁以下儿童的年发病率在疫苗接种前的年份达到每10万人450 - 860例的峰值，但在该年龄组中降至每10万人7.5例，在疫苗接种开始一年后，总人口中的发病率降至每10万人3.2例。自2016年以来，图瓦未报告过甲型肝炎病例。对单剂量疫苗接种后的健康儿童样本进行血清抗HAV抗体定量检测。单剂量免疫后1个月检测的儿童中，98.0%（95%置信区间：96.2 - 99.0%（442/451））检测到保护性抗HAV抗体浓度（≥10 mIU/mL），单剂量免疫后1年和5年检测的儿童中这一比例分别为93.5%（95%置信区间：91.0 - 95.4%（477/510））和91.1%（95%置信区间：88.2 - 93.4%（422/463））。单剂量疫苗接种后1个月、1年和5年采集的血清中，抗HAV抗体几何平均浓度相似，分别为40.24 mIU/mL、44.96 mIU/mL和57.73 mIU/mL（P>0.05）。这些数据证实，在高流行地区，单剂量疫苗接种是在短时间内控制甲型肝炎的有效方法。
