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Assessing the effectiveness of the expanded hepatitis A vaccination program in China: an interrupted time series design
BMJ Global Health ( IF 8.1 ) Pub Date : 2024-02-01 , DOI: 10.1136/bmjgh-2023-013444 Yueqian Wu , Pengyu Wang , Yong Huang , Jinwei Chen , Yikun Chang , Junxi Li , Yibing Wang , Yuantao Hao , Wangjian Zhang , Zhicheng Du
BMJ Global Health ( IF 8.1 ) Pub Date : 2024-02-01 , DOI: 10.1136/bmjgh-2023-013444 Yueqian Wu , Pengyu Wang , Yong Huang , Jinwei Chen , Yikun Chang , Junxi Li , Yibing Wang , Yuantao Hao , Wangjian Zhang , Zhicheng Du
Introduction China initialised the expanded hepatitis A vaccination programme (EHAP) in 2008. However, the effectiveness of the programme remains unclear. We aimed to comprehensively evaluate the effectiveness of EHAP in the country. Methods Based on the provincial data on the incidence of hepatitis A (HepA), the population and meteorological variables in China, we developed interrupted time series (ITS) models to estimate the effectiveness of EHAP with the autocorrelation, seasonality and the meteorological confounders being controlled. Results were also stratified by economic zones, age groups and provinces. Results We found a 0.9% reduction (RR=0.991, 95% CI: 0.990 to 0.991) in monthly HepA incidence after EHAP, which was 0.3% greater than the reduction rate before EHAP in China. Across the three economic regions, we found a 1.1% reduction in HepA incidence in both central and western regions after EHAP, which were 0.3% and 1.2% greater than the reduction rates before EHAP, respectively. We found a decreased reduction rate for the eastern region. In addition, we found generally increased reduction rate after EHAP for age groups of 0–4, 5–14 and 15–24 years. However, we found decreased reduction rate among the 25–64 and ≥65 years groups. We found a slight increased rate after EHAP in Shanxi Province but not elsewhere. Conclusion Our finding provides comprehensive evidence on the effectiveness of EHAP in China, particularly in the central and western regions, and among the population aged 0–24 years old. This study has important implications for the adjustment of vaccination strategies for other regions and populations. Data are available in a public, open access repository. The authors do not have permission to share data. The monthly reported incidence data of HepA are publicly available at . The annual population data by age groups are publicly available at . The annual population data by provinces are publicly available at . The monthly temperature and precipitation data are publicly available at .
更新日期：2024-02-06
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