Single-Dose Universal Hepatitis A Immunization in 1-Year-Old Infants in Argentina: High Prevalence of Protective Antibodies up to 11 Years Following Vaccination

Abstract Background Single-dose Hepatitis A Virus (HAV) vaccination was implemented for all Argentinean children aged 12 months in 2005, instead of the standard two-dose schedule. Previous studies demonstrated a dramatic decline in HAV infection rates, fulminant hepatitis, and liver transplantation along with low viral circulation and high prevalence of protective antibody response 8 years following the intervention. This study assessed long-term seroprotection against HAV after vaccination with this novel scheme. Methods Children who received one dose of HAV vaccine at 1 year of age, at least nine years before enrollment, were included at three centers in Argentina between May 2015 and April 2016. Demographic and socio-economic characteristics of the child, mother and house were collected through a questionnaire after informed consent signature. Blood samples were tested for anti-HAV antibodies. Antibody titers ≥10 mIU/mL were considered seroprotective. Logistic regression analysis was done to evaluate associations between different variables and seroprotection. Results Of 1119 children included, 97.0% lived in urban areas, 92.7% had safe water access and 57.8% had sewers at home. Mean age was 10.7 years, and the mean post-vaccination interval was 9.7 years (Range: 9.0–11.3 years). Of the total, 87.6% had protective antibodies against HAV. Higher seroprotection rates were observed in Santa Fe compared with the global rate (91.9% vs. 87.6%; OR 1.94 (95% CI: 1.27–2.95); P = 0.002). In contrast, lowest rates resulted in San Justo, Buenos Aires (81.4% vs. 87.6% OR 0.45 (95% CI: 0.32–0.65); P <0.001). No association between socio-economic variables and seroprotection was found. Geometric mean concentration (GMC) of HAV Ab titers was 28.0 mIU/mL (95% CI: 26.8–29.3 mIU/mL). Conclusion Single-dose universal hepatitis A immunization in infants resulted in sustained immunologic protection up to 11 years in Argentina. Lower seroprevalence rates in San Justo have no clear reason and were not associated with an increase in HAV cases in that area. These findings, along with the low current disease burden confirm the success of the intervention. Disclosures All authors: No reported disclosures.