Assessing the effectiveness of the expanded hepatitis A vaccination program in China: an interrupted time series design.
BMJ Glob Health
; 9(2)2024 02 06.
Article
em En
| MEDLINE
| ID: mdl-38320803
ABSTRACT
INTRODUCTION:
China initialised the expanded hepatitis A vaccination programme (EHAP) in 2008. However, the effectiveness of the programme remains unclear. We aimed to comprehensively evaluate the effectiveness of EHAP in the country.METHODS:
Based on the provincial data on the incidence of hepatitis A (HepA), the population and meteorological variables in China, we developed interrupted time series (ITS) models to estimate the effectiveness of EHAP with the autocorrelation, seasonality and the meteorological confounders being controlled. Results were also stratified by economic zones, age groups and provinces.RESULTS:
We found a 0.9% reduction (RR=0.991, 95% CI 0.990 to 0.991) in monthly HepA incidence after EHAP, which was 0.3% greater than the reduction rate before EHAP in China. Across the three economic regions, we found a 1.1% reduction in HepA incidence in both central and western regions after EHAP, which were 0.3% and 1.2% greater than the reduction rates before EHAP, respectively. We found a decreased reduction rate for the eastern region. In addition, we found generally increased reduction rate after EHAP for age groups of 0-4, 5-14 and 15-24 years. However, we found decreased reduction rate among the 25-64 and ≥65 years groups. We found a slight increased rate after EHAP in Shanxi Province but not elsewhere.CONCLUSION:
Our finding provides comprehensive evidence on the effectiveness of EHAP in China, particularly in the central and western regions, and among the population aged 0-24 years old. This study has important implications for the adjustment of vaccination strategies for other regions and populations.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Temas:
Acesso_medicamentos_insumos_estrategicos
Contexto em Saúde:
1_ASSA2030
/
2_ODS3
/
4_TD
Base de dados:
MEDLINE
Assunto principal:
Hepatite A
Tipo de estudo:
Evaluation_studies
/
Incidence_studies
/
Prognostic_studies
Limite:
Adolescent
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Adult
/
Child
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Child, preschool
/
Humans
/
Infant
/
Newborn
País/Região como assunto:
Asia
Idioma:
En
Revista:
BMJ Glob Health
Ano de publicação:
2024
Tipo de documento:
Article