Hepatitis A vaccines and the elderly.

Details

Serval ID
serval:BIB_72DD599F5869
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Hepatitis A vaccines and the elderly.
Journal
Travel Medicine and Infectious Disease
Author(s)
Genton B., D'Acremont V., Furrer H.J., Hatz C., Loutan L.
ISSN
1477-8939 (Print)
ISSN-L
1477-8939
Publication state
Published
Issued date
2006
Volume
4
Number
6
Pages
303-312
Language
english
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Abstract
Hepatitis A virus (HAV) exposure in unprotected adults may cause severe and serious symptoms, with risk of both morbidity and mortality increasing with age. As seroprevalence of HAV is low in industrialised countries, and an increasing number of people, with an increasing median age, travel from areas of low HAV endemicity to high endemicity, pre-travel vaccination is warranted. Vaccination of the elderly against HAV, however, may be associated with reduced seroprotection, since the immune response decreases with age. Studies with monovalent hepatitis A vaccine or combined hepatitis A and B vaccine show good efficacy in adults in general. Few studies have assessed the immune response in older adults. The only prospective study with monovalent hepatitis A vaccine in the elderly showed a reduced seroprotection of approximately 65% after a single primary dose in subjects over the age of 50 years, while seroprotection was 98% in this age group after receiving a booster dose. The only prospective study with combined hepatitis A and B vaccine in younger subjects or older than 40 years showed similar seroprotection (99-100%) against HAV compared to a monovalent vaccine after receiving three doses. As data on seroprotection for HAV in the elderly are limited, further studies are needed to elucidate how optimal protection in the elderly can be achieved. In the mean time, based on the available data, the suggestion is made to screen elderly travellers to areas endemic for HAV for the presence of naturally acquired immunity, and, if found susceptible, be immunised well in advance of their trip, to allow time for post-vaccination antibody testing and/or administration of a second dose of the vaccine.
Keywords
Age Factors, Aged, Aged, 80 and over, Aging/immunology, Hepatitis A/immunology, Hepatitis A/prevention & control, Hepatitis A Vaccines/administration & dosage, Hepatitis A Vaccines/standards, Humans, Immunization, Secondary, Travel, Vaccination
Pubmed
Create date
28/01/2008 11:49
Last modification date
20/08/2019 14:31
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