Hepatitis A vaccination will be cost-effective in Kerala: study

Sub : Science and tech

Sec: Health

Hepatitis A virus:

Hepatitis A is an inflammation of the liver that can cause mild to severe illness.
The hepatitis A virus (HAV) is transmitted through ingestion of contaminated food and water or through direct contact with an infectious person.
Almost everyone recovers fully from hepatitis A with a lifelong immunity. However, a very small proportion of people infected with hepatitis A could die from fulminant hepatitis.
The risk of hepatitis A infection is associated with a lack of safe water and poor sanitation and hygiene (such as contaminated and dirty hands).
A safe and effective vaccine is available to prevent hepatitis A.
Risk factors include:
- poor sanitation;
- lack of safe water;
- living in a household with an infected person;
- being a sexual partner of someone with acute hepatitis A infection;
- use of recreational drugs;
- sex between men; and
- travelling to areas of high endemicity without being immunized.

Epidemiological Transition of Hepatitis A in Kerala:

With better sanitation and hygiene, Hepatitis A infection is transitioning from early childhood to adolescents and young adults.
In young children (under six), the infection is mild and often asymptomatic.
In older children and adults, the infection is symptomatic and can lead to severe health issues, including liver injury and death.

Outbreaks and Current Situation:

Kerala has experienced regular hepatitis A outbreaks over the past two decades, with annual occurrences since 2017.
The 2024 outbreak is the largest, with over 2,400 cases and 18 deaths reported by May 30, 2024.
Most cases this year are from Kozhikode, Malappuram, Thrissur, and Ernakulam districts.

Impact of Improved Sanitation:

Better sanitation and hygiene have reduced early childhood infections, leaving older individuals more vulnerable.
Infected children develop lifelong immunity, which is lacking in those who were not exposed early due to improved conditions.

Vaccination:

Vaccination is proposed as a solution to reduce outbreaks and health expenditures.
A study in PLOS ONE recommends vaccinating children aged one year and adolescents aged 15 years.
Vaccines considered:
- Live, attenuated vaccine: Requires one dose.
- Inactivated vaccine: Requires two doses.

Challenges and Recommendations:

High vaccination coverage (90%) is necessary to achieve benefits, currently met only for infants.
Adolescents are harder to vaccinate as they fall outside the universal immunization program.
Suggested strategy: School-based vaccination and effective campaigns for adolescents.

Source: TH