Six Years' Follow-up after Hepatitis A Vaccination

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Abstract
Epidemics of hepatitis A occurred in four of the six years preceding the Monroe efficacy trial 1 of an inactivated hepatitis A vaccine (VAQTA).2 Post-trial surveillance included semiannual household telephone surveys, county disease-report surveys, and physical examinations, and γ-glutamyltransferase and IgM antibody tests in suspected cases. In six post-trial years, despite sporadic cases in people who were not vaccinated, Monroe has had no hepatitis A outbreaks or cases among vaccinated people, whereas in three similar, unvaccinated neighboring communities the combined annual cases for 1993 through 1997 totaled 31, 38, 106, 53, and 6. Our data suggest the degree of vaccine coverage needed for outbreak control, a mechanism for long-term protection, and the time interval between vaccination and protection.

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