The Burden of Hepatitis A in Texas Before and After Vaccination Legislation
Date
2005-12
Authors
Johnson, Kelly M. K.
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Abstract
Hepatitis A is one of the most commonly reported vaccine-preventable diseases in
Texas. The virus that causes hepatitis A is primarily spread via the fecal-oral route.
Children play an important role in spread of the disease as infected children are often
asymptomatic and because most have poorly developed personal hygiene. A licensed
vaccine against hepatitis A has been available since the 1995, but it was not listed among
the recommended childhood vaccines until recently. The vaccine has been required for
children entering school in select Texas counties beginning in 1999. The objective of this
study is to determine if routine vaccination against hepatitis A in children can reduce
disease incidence. Deidentified hepatitis A surveillance records were obtained from the
Texas Department of State Health Services. Incidence rates adjusted for age and race/ethnicity, along with their corresponding 95% confidence limits, were calculated for
the time before versus the time after vaccination against hepatitis A became required for
school-age children in applicable counties. Results indicate that rates of hepatitis A
infection have decreased in Texas beginning in 1999. Hispanic Texans have the highest rates both before and after vaccination legislation; however, all racial-ethnic groups had significantly decreased incidence after vaccination became a requirement. Children ages 0 to 9 years had the highest incidence rates; however, all age groups experienced significantly decreased incidence after legislation. The results of this study suggest that vaccination requirements for school-age children were successful in reducing the burden
of hepatitis A infection in Texas. Further investigation is required to determine why
hepatitis A vaccination rates lag behind those for other diseases for which vaccination is
required for school attendance and to investigate the efficacy and cost effectiveness in
controlling infection in certain special populations ( those living in prisons or nursing
homes, children, college students living in dormitories, etc).
Description
Keywords
Hepatitis A--Texas, Vaccines--Texas, Vaccines--Health aspects
Citation
Johnson, K. M. K. (2005). <i>The burden of hepatitis A in Texas before and after vaccination legislation</i> (Unpublished thesis). Texas State University-San Marcos, San Marcos, Texas.