Age characteristics of the hepatitis A epidemic process in federal districts of Russia in the modern period. Justifications of the introduction of a children's routine hepatitis A vaccination

In recent years, there were published several epidemiological observations concerning the maximum incidence of hepatitis A (HA) shifting into the older age groups, including adolescents aged 15-19 and young adults 20-39 years old, and the reduction of the role of children as a significant risk group. These phenomena have not been sufficiently studied yet and have not received an adequate explanation. The aim of this study is to investigate the age characteristics of the epidemic process of the HA in Russian Federation and federal districts in the modern period to assess the need for routine vaccination of children against the infection, as well as to determine the optimal age for its implementation. There was conducted a comparative analysis of age-related morbidity of Hepatitis A (the proportion of children and adults, the ratio of adults and children’s rates, the intensity of the population) in the federal districts of the Russian Federation in 1999, 2001 and 2010. It was discovered that Hepatitis A remains a significant child problem in Russian Federation. The proportion of children aged 0-14 years among Hepatitis A cases in 2010 (28%) was not significantly different from that in 1999 (40%). In the Far East, Siberia and the North Caucasus the incidence of children is continuously increasing 4-6 times faster than those of adults. These characteristics of the epidemic process of Hepatitis A indicate the need for the introduction of a routine vaccination of children.