The impact of expanded program on immunization with live attenuated and inactivated Hepatitis A vaccines in China, 2004-2016.

INTRODUCTION: Since 2008, two types of hepatitis A (HepA) vaccines were integrated into the expanded program on immunization (EPI) in China. Children were given either one dose of live attenuated HepA (L-HepA) or two doses of inactivated HepA (I-HepA), depending on geographic regions. We sought to evaluate the impact of the EPI on HepA incidence in China.

METHODS: We reviewed the epidemiology of HepA during 2004-2016 from National Notifiable Disease Reporting System (NNDRS). We collected data of L-HepA and I-HepA coverage from Children Immunization Information Management System (CIIMS). Based on the regions where two types of HepA vaccines were used, the coverage and incidence of HepA were compared over time.

RESULTS: In 2008-2016, the HepA vaccine coverage was 98.8% among target children, with 99.6% in I-HepA region and 98.7% in L-HepA region. HepA incidence declined by 78.0% and 82.3% in L-HepA region and I-HepA region, respectively, without significant difference. Dramatic decline were seen in all age groups of both regions.

CONCLUSION: The study suggests that the EPI, with high coverage for both I-HepA and L-HepA, had positive impact on HepA incidence in China.