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Changes in the epidemiology of hepatitis A outbreaks 13 years after the introduction of a mass vaccination program.
Hum Vaccin Immunother. 2015; 11(1):192-7.HV

Abstract

A hepatitis A+B vaccine vaccination program of 12-year-olds was introduced in Catalonia in 1998. The aim of this study was to investigate the evolution of hepatitis A outbreaks in Catalonia and estimate the preventable fraction of cases associated with outbreaks as a measure of the impact of the vaccination program. Hepatitis A outbreaks reported to the Health Department between 1991 and 2012 were analyzed. The incidence rates of outbreaks, outbreak-associated cases and hospitalizations were calculated. The preventable fraction (PF) and 95% confidence intervals (CI) were estimated for the whole study period (pre-vaccination and post-vaccination) and the post-vaccination period. One-hundred-eight (108) outbreaks (rate of 2.21 per 10(6) persons-year) were reported in the pre-vaccination period and 258 outbreaks (rate of 2.82 per 10(6) persons-year) in the post-vaccination period. The rate of cases associated with outbreaks was 1.52 per 10(5) persons-year in the pre-vaccination period and 1.28 per 10(5) persons-year in the post-vaccination period. Hospitalization rates were 0.08 and 0.75 per 10(6) persons-year, respectively. The number of person-to-person outbreaks whose index case was a school contact decreased in the post-vaccination period (aOR 2.72; 95%CI 1.35-5.48), but outbreaks whose index case was a man who has sex with men (MSM) or an immigrant increased. The PF of all outbreak-associated cases was 6.46% (95%CI 3.11-9.82) and the highest PF was in the 15-24 years age group (42.53%; 95%CI 29.30-55.75). In the 0-4 years age group, the PF was 18.35% (95%CI 9.59-27.11), suggesting a protective herd effect in unvaccinated subjects. Vaccination of immigrants traveling to endemic countries and MSM should be reinforced.

Authors+Show Affiliations

a Public Health Agency of Catalonia; Generalitat of Catalonia, Spain.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25483535

Citation

Martínez, Ana, et al. "Changes in the Epidemiology of Hepatitis a Outbreaks 13 Years After the Introduction of a Mass Vaccination Program." Human Vaccines & Immunotherapeutics, vol. 11, no. 1, 2015, pp. 192-7.
Martínez A, Broner S, Sala MR, et al. Changes in the epidemiology of hepatitis A outbreaks 13 years after the introduction of a mass vaccination program. Hum Vaccin Immunother. 2015;11(1):192-7.
Martínez, A., Broner, S., Sala, M. R., Manzanares-Laya, S., Godoy, P., Planas, C., Minguell, S., Torner, N., Jané, M., Domínguez, A., For The Study Of The Immune Status In Health Care, T. W., & Hepatitis A In Catalonia, F. T. (2015). Changes in the epidemiology of hepatitis A outbreaks 13 years after the introduction of a mass vaccination program. Human Vaccines & Immunotherapeutics, 11(1), 192-7. https://doi.org/10.4161/hv.35861
Martínez A, et al. Changes in the Epidemiology of Hepatitis a Outbreaks 13 Years After the Introduction of a Mass Vaccination Program. Hum Vaccin Immunother. 2015;11(1):192-7. PubMed PMID: 25483535.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Changes in the epidemiology of hepatitis A outbreaks 13 years after the introduction of a mass vaccination program. AU - Martínez,Ana, AU - Broner,Sonia, AU - Sala,M Rosa, AU - Manzanares-Laya,Sandra, AU - Godoy,Pere, AU - Planas,Caritat, AU - Minguell,Sofia, AU - Torner,Nuria, AU - Jané,Mireia, AU - Domínguez,Angela, AU - For The Study Of The Immune Status In Health Care,The Working Group, AU - Hepatitis A In Catalonia,For The Study Of, Y1 - 2014/11/01/ PY - 2014/12/9/entrez PY - 2014/12/9/pubmed PY - 2015/10/27/medline KW - Hepatitis A KW - hospitalization KW - incidence rate KW - mass immunization program KW - outbreak KW - preventable fraction SP - 192 EP - 7 JF - Human vaccines & immunotherapeutics JO - Hum Vaccin Immunother VL - 11 IS - 1 N2 - A hepatitis A+B vaccine vaccination program of 12-year-olds was introduced in Catalonia in 1998. The aim of this study was to investigate the evolution of hepatitis A outbreaks in Catalonia and estimate the preventable fraction of cases associated with outbreaks as a measure of the impact of the vaccination program. Hepatitis A outbreaks reported to the Health Department between 1991 and 2012 were analyzed. The incidence rates of outbreaks, outbreak-associated cases and hospitalizations were calculated. The preventable fraction (PF) and 95% confidence intervals (CI) were estimated for the whole study period (pre-vaccination and post-vaccination) and the post-vaccination period. One-hundred-eight (108) outbreaks (rate of 2.21 per 10(6) persons-year) were reported in the pre-vaccination period and 258 outbreaks (rate of 2.82 per 10(6) persons-year) in the post-vaccination period. The rate of cases associated with outbreaks was 1.52 per 10(5) persons-year in the pre-vaccination period and 1.28 per 10(5) persons-year in the post-vaccination period. Hospitalization rates were 0.08 and 0.75 per 10(6) persons-year, respectively. The number of person-to-person outbreaks whose index case was a school contact decreased in the post-vaccination period (aOR 2.72; 95%CI 1.35-5.48), but outbreaks whose index case was a man who has sex with men (MSM) or an immigrant increased. The PF of all outbreak-associated cases was 6.46% (95%CI 3.11-9.82) and the highest PF was in the 15-24 years age group (42.53%; 95%CI 29.30-55.75). In the 0-4 years age group, the PF was 18.35% (95%CI 9.59-27.11), suggesting a protective herd effect in unvaccinated subjects. Vaccination of immigrants traveling to endemic countries and MSM should be reinforced. SN - 2164-554X UR - https://www.unboundmedicine.com/medline/citation/25483535/Changes_in_the_epidemiology_of_hepatitis_A_outbreaks_13_years_after_the_introduction_of_a_mass_vaccination_program_ L2 - https://www.tandfonline.com/doi/full/10.4161/hv.35861 DB - PRIME DP - Unbound Medicine ER -