Lemon S M, Shapiro C N
Department of Medicine, University of North Carolina at Chapel Hill 27599-7030.
Infect Agents Dis. 1994 Feb;3(1):38-49.
Safe and effective inactivated vaccines should soon be available for prevention of hepatitis A virus infections in the United States. Here we review the heterogeneous distribution of hepatitis A cases among different risk groups, age groups, and geographic regions of the United States and comment on several possible strategies for using hepatitis A vaccines in immunization programs. We conclude that immunization targeted exclusively at groups that are at high risk of developing hepatitis A is unlikely to significantly lower national rates of the disease. While universal immunization of young children may accomplish this goal, such a practice is likely to prove unacceptably costly. Alternative strategies worthy of consideration include immunization targeted to specific risk groups on a regional basis, based on knowledge of the local epidemiology of hepatitis A.
安全有效的甲型肝炎灭活疫苗不久将在美国上市，用于预防甲型肝炎病毒感染。在此，我们回顾了美国不同风险群体、年龄组和地理区域之间甲型肝炎病例的分布差异，并对免疫规划中使用甲型肝炎疫苗的几种可能策略进行了评论。我们得出结论，仅针对甲型肝炎高风险人群进行免疫接种不太可能显著降低全国的发病率。虽然对幼儿进行普遍免疫接种可能实现这一目标，但这种做法的成本可能高得令人难以接受。值得考虑的替代策略包括根据当地甲型肝炎的流行病学知识，在区域基础上针对特定风险群体进行免疫接种。
