Safety and immunogenicity of an inactivated hepatitis A vaccine in children 2 to 5 years old

The reactogenicity and immunogenicity of an inactivated hepatitis A vaccine were assessed. Seventy healthy children aged between 2 and 5 years old, who lacked antibodies against the hepatitis A virus, were enrolled in this study. With a 0-, 1-, and 6-month vaccination schedule, the children received three doses of 360 enzyme-linked immunosorbent assay (ELISA) units of hepatitis A vaccine intramuscularly (deltoid). Safety parameters were recorded in standardized diary cards by the parents on the day of injection and the three following days. Blood tests for liver enzymes and anti-hepatitis A virus antibody analyses were performed the day of screening and 1, 2, 6 and 7 months after the first dose. Anti-hepatitis A virus antibody was tested by ELISA. Titres < 20 mIU/ml were considered negative. For the three hepatitis A vaccine doses administered, 22% (46/210) of the diary cards reported any kinds of signs or symptoms. Soreness at the injection site (9%, 18/210) and malaise (6%, 12/210) were the most common local and systemic reactions reported, respectively. The seroconversion rates were 83, 99 and 100% one month after the 1st, 2nd, and 3rd doses, respectively. The corresponding geometric mean titres were 124, 352, and 2,778 mIU/ml. We conclude that this HAV vaccine is safe and immunogenic in healthy children. As the hepatitis A epidemiology pattern is rapidly changing in our country (and other regions), resulting in an increasing population of susceptible adolescents and young adults, we suggest that the routine vaccination against hepatitis A in pre-school children attending day-care centres should be seriously considered.