1 / 16

Hepatitis A Issues and IAPCOI perspectives

Hepatitis A Issues and IAPCOI perspectives. Dr Monjori Mitra Associate Professor Institute of Child Health Kolkata. Vaccination schedule. Should depend on the seroepidemiology of the disease. Vaccine type – immunogenecity and safety of the vaccine

vesna
Download Presentation

Hepatitis A Issues and IAPCOI perspectives

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Hepatitis A Issues and IAPCOI perspectives DrMonjoriMitra Associate Professor Institute of Child Health Kolkata

  2. Vaccination schedule • Should depend on the seroepidemiology of the disease. • Vaccine type – immunogenecity and safety of the vaccine • Objective should be focussed on taking strategy to increase the coverage in endemic areas where disease is becoming a major complication.

  3. Inactivated Hepatitis A Vaccine Hepatitis A vaccines are all highly immunogenic Protective efficacy - 100% in adults after a single dose of vaccine within a month. Protective efficacy – 94% (95% confidence intervals: 82%–99%) following two doses in Thai population 1-16 yrs. Among approximately 1000 children aged 2–16 years, living in a highly disease-endemic community in the United States, the efficacy of one dose of vaccine was 100% (95% confidence intervals: 87%–100%). WHO Position Paper 2000

  4. Why ? Live attenuated Vaccine Killed HAV vaccine cannot mimic the immune effect produced by natural infection of HAV. Since lifelong immunity following vaccination is very important in countries where childhood immunization is needed and where revaccination is not practical, the disadvantages of a killed vaccine are more conspicuous in China, with its high incidence of hepatitis A, huge population and low economic level. A better alternative to a killed vaccine is live, attenuated HAV vaccine. A programme aimed at developing such a vaccine was set up in China in 1980. Vaccine, Vol. 8, December 1990

  5. Persistent Efficacy of live attenuated Hepatitis A Vaccine (H2) strain after a mass vaccination program

  6. Persistence of anti-HAV antibody after 4 years – Multicentric study in India Unpublished: Faridi MMA, Shah N, Ghosh A, Sankaranarayanan VS, Mitra M

  7. Anti-HAV IgG prevalence by City(n = 1612) Indian J Gastroenterol 2001

  8. Seroprevalence of Hepatitis A across different states in India 2011 Interim report n = 934 % seropositive – 37.96%

  9. Centre wise Seroprevalence of HAV:

  10. Age wise seroprevalence in different centres

  11. Seroprevalence based on SES in different centres

  12. Hepatitis A Vaccine • Two types of HAV vaccines are currently available internationally: • Formaldehyde-inactivated hepatitis A virus vaccines. Inactivated HAV vaccines are used in most countries. Monovalent inactivated HAV vaccines are available in paediatric dose (0.5 ml) for children aged >1 year to 15 years, and in adult dose (1 ml). • 2) Live attenuated vaccines (based on H2 and LA-1 HAV strains). These vaccines are manufactured and used mainly in China and sporadically in the private sector in India.

  13. Type of vaccine: Inactivated or live. Number of doses: Inactivated vaccine: two; live vaccine: one Schedule: Inactivated vaccine: two doses, the second dose normally 6 months after the first. If needed, this interval may be extended to 18–36 months). 
Live vaccine: one dose. Minimum age for HAV vaccination is 1 year. Boosters: May not be necessary

  14. Contraindications: Hypersensitivity to previous dose Adverse reactions: Inactivated vaccine: mild local reaction of short duration, mild systemic reaction. 
Live vaccine: few reported Before departure: Inactivated and live vaccines: protection is achieved 2–4 weeks after first dose. Given the long incubation period of hepatitis A (average 2–4 weeks), the vaccine can be administered up to the day of departure and still protect travellers. Recommended for: All non-immune travellers to countries or areas at risk Special precautions: None 


  15. Widely heterogenous pockets in epidemiology status in India • Changing epidemiology • Increased incidence of complicated hepatitis A with FHF • Adequate evidence both India and China demonstrated single dose gives long term immunogenecity. • Highly endemic countries in Europe have reduced HAV incidence by single dose of inactivated vaccine

  16. Based on the current evidence to be presented by DrNitin Shah We need to decide One dose or two dose for live attenuated vaccine.

More Related