Abstract
In 2014, Brazil introduced a universal immunization program against the hepatitis A virus (HAV) for children in the second year of life, using a single dose of inactivated virus vaccine. The objective of this study was to evaluate the vaccination coverage (VC) against HAV in Brazil, against the incidence of cases reported five years after the implementation of the program. Secondary data were obtained by searching free access electronic sites of the Ministry of Health, Department of Informatics of the Unified Health System (Departamento de Informática do Sistema Único de Saúde - DATASUS), for incidence analysis and VC from 2014 to 2018. VC ranged from 60.13 to 97.07%. The homogeneity of VC against hepatitis A did not reach the established goal throughout all states but for a few exceptions. After 2015, CV decreased in all regions of the country. Despite insufficient coverage, a concomitant reduction in the incidence of Hepatitis A took place throughout the country. The incidence rate fell from 3.29 to 0.80/100,000 between 2014 and 2018. However, there was an interruption in the pace of incidence fall between 2017 and 2018, which may be a consequence of insufficient VC. This phenomenon seems to be part of a widespread downward trend in vaccination effort across the country, also verified for other vaccines, such as poliomyelitis and measles, mumps and rubella vaccine. These figures suggest the need for implementing efforts to improve hepatitis A VC rates in the country.
Highlights
In 2014, Brazil introduced a universal immunization program against the hepatitis A virus (HAV) for children in the second year of life, using a single dose of inactivated virus vaccine
In Brazil, from August 2014 to December 2018, a total of 11,397,607 children under 2 years of age were vaccinated with a single dose of the inactivated virus vaccine against monovalent HAV (VaqtaTM Ped/Adol, Merck Sharp & Dohme — approximately 25 U of HAV antigen)
In 2014, there was a higher VC in the South Region (70.72%), Universal hepatitis A vaccination in Brazil: analysis of vaccination coverage and incidence five years after program implementation followed by the Southeast Region (66.90%)
Summary
In 2014, Brazil introduced a universal immunization program against the hepatitis A virus (HAV) for children in the second year of life, using a single dose of inactivated virus vaccine. The objective of this study was to evaluate the vaccination coverage (VC) against HAV in Brazil, against the incidence of cases reported five years after the implementation of the program. There was an interruption in the pace of incidence fall between 2017 and 2018, which may be a consequence of insufficient VC This phenomenon seems to be part of a widespread downward trend in vaccination effort across the country, verified for other vaccines, such as poliomyelitis and measles, mumps and rubella vaccine. In addition to improving health conditions, universal vaccination of children is an important tool to control the circulation of HAV and to decrease the incidence of the disease. With the second application between 6 and 18 months after the first one, the vaccine is very expensive, limiting its large-scale implementation to countries with better economic conditions[5,6]
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