Quantifying the population effects of vaccination and migration on hepatitis A seroepidemiology in Australia |
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| Institution: | 1. School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia;2. The Kirby Institute, University of New South Wales, Sydney, NSW 2052, Australia;1. Baker IDI Heart and Diabetes Institute, Melbourne, Australia;2. School of Primary Health Care, Monash University, Melbourne, Australia;1. Department of ENT Head & Neck Surgery, Nordsjællands Hospital, Dyrehavevej 29, 4000 Hillerød, Denmark;2. Department of Microbiology and Infection Control, Statens Serum Institut, Artillerivej 5, 2300 Copenhagen S, Denmark;3. Department of Infectious Diseases, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark;4. Department of Pediatrics, Næstved Hospital, Ringstedgade 61, 4700 Næstved, Denmark;5. Department of Infectious Disease Epidemiology, Statens Serum Institut, Artillerivej 5, 2300 Copenhagen S, Denmark;6. Epidemiology, Biostatistics and Biodemography, University of Southern Denmark, J.B. Winsløws Vej 9 B, 5000 Odense C, Denmark;7. Department of ENT Head & Neck Surgery, Zealand University Hospital, Lykkebækvej 1, 4600 Køge, Denmark;1. Institut National de la Santé et de la Recherche Médicale, Unit 1018, Centre for Research in Epidemiology and Population Health, Villejuif, France;2. Internal Medicine and Infectious Diseases, Groupe Hospitalier Universitaire Paris Centre, APHP, Paris, France;3. Samusocial International, Ivry sur Seine, France;4. Samusocial Casablanca, Morocco;5. Samusocial Bamako, Mali;6. Samusocial Ouagadougou, Burkina Faso;7. Samusocial Bruxelles, Belgium;8. Samusocial Dakar, Senegal;9. Service d’Aide Médicale Urgente (SAMU), Hôpital Necker, APHP, Paris, France;1. Department of Pediatrics (Hospital Medicine and Infectious Diseases), University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, CO, USA;2. University of Colorado School of Medicine, Adult and Child Center for Health Outcomes Research and Delivery Science, Aurora, CO, USA;3. Department of Pediatrics, University of Maryland School of Medicine, MD, USA;4. Department of Pediatrics (Hospital Medicine), University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, CO, USA;5. Department of Pediatrics, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, CO, USA;6. Department of Pediatrics (Infectious Diseases), University of Colorado School Of Medicine and Children’s Hospital Colorado, Aurora, CO, USA;1. George Mason University, Department of Global and Community Health, 4400 University Drive, Fairfax, VA 22030, United States;2. Emory University, Rollins School of Public Health, Department of Behavioral Sciences and Health Education, 1518 Clifton Road, Atlanta, GA 30322, United States;3. Emory University, Emory Vaccine Center, Hope Clinic, 500 Irvin Court, Suite 200, Decatur, GA 30030, United States;4. Emory University, School of Medicine, Division of Infectious Diseases, 500 Irvin Court, Suite 200, Decatur, GA 30030, United States;1. Avenue JP Rullens 9, 1200 Brussels, Belgium;2. Center for Global Health, Cincinnati Children''s Hospital, Cincinnati, OH, USA |
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| Abstract: | Since licensure of hepatitis A vaccine in Australia in 1994, infection rates have declined to record lows. Cross-sectional serosurveys conducted over this period meanwhile have shown rising population immunity, particularly in young to middle-aged Australians. In this study, we performed a retrospective birth cohort analysis to estimate the contributions of infection, migration and vaccination towards increased levels of age specific hepatitis A seroprevalence in Australia. When aggregated across age, we find that two-thirds of the increase in population seropositivity (67.04%) between 1994 and 2008 was due to vaccination, just under one-third due to migration, with a negligible contribution from infection (<1%). Comparisons with other data sources reflecting vaccine uptake suggest the magnitude of this effect is realistic. We suggest that these results primarily relate to opportunistic vaccination and indicate the level of population immunity achievable through opportunistic programs providing further evidence for policy considerations around universal hepatitis A vaccine recommendations. |
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| Keywords: | Hepatitis A Seroepidemiology Vaccination Migration |
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