The Impact of Hepatitis A Vaccination

Worldwide the prevalence of Hepatitis A virus in various countries are grouped into high, intermediate low and very low endemicity. Even in USA having very low endemicity have incidence of acute hepatitis A of 12.0 cases/100,000 persons in 1995.To prevent mortality and morbidity related with Hepatitis A virus infection, after implementation of routine childhood Hepatitis A vaccination in USA the incidence of acute Hepatitis A infection has declined by 92% in 2007. Routine childhood vaccination has produced similar results in Israel, Spain, Australia and selected region of Italy. But in countries of Asia, Latin America, Middle East and Eastern Europe having intermediate or low endemicity , implementation of routine childhood Hepatitis A vaccination has not been done. Although there is variation in HAV sero-prevalence rates in these country due to economic growth and improving hygiene conditions in these countries. In India there is heterogenous exposure of Hepatitis A virus in different region of the country. There is transition of anti-HAV prevalence from high to intermediate endemicity in urban population which has lead to increase in frequency of acute viral Hepatitis A infection from 10.6% to 22.0% in five years period (1999-2003). A extensive nationwide epidemiological evaluation of anti-HAV sero-prevalence, cost-benefit analysis for HAV infection with subsequent framing of guidelines for the same is urgently needed in our context.