Vaccination against hepatitis viruses in Poland

March 28, 2001

Vaccine 2001 Mar 21;19(17-19):2384-8

Vaccination against hepatitis viruses in Poland.

Slusarczyk J

Department of Sera and Vaccines Evaluation, National Institute of Hygiene,

Chocimska st. 24, 00-791, Warsaw, Poland

[Medline record in process]

At present, two etiologic varieties of viral hepatitis (VH) can be directly

vaccine-preventable: VH type A and VH type B. In addition, VH type D can be

prevented indirectly through vaccination against VH-B. The first

commercially available vaccine against VH-B appeared in 1981 and was human

plasma-derived. After several years, it has generally been replaced by a

recombinant type of vaccines. The obvious benefits of vaccination against

VH-B prompted its introduction into the national immunization program in

Poland in 1989. At that time, vaccination was offered free of charge to

high-risk groups: newborns of HBsAg-carrier mothers, health-care workers,

students: at medical schools, nursing schools, medical technology schools,

and caretakers at institutions for mentally retarded persons. However,

similarly to the experiences of other countries, observations in Poland

indicated that such a targeted strategy fails to induce major

epidemiological changes. In 1989 and in 1993, the incidence of VH-B per

100000 was 40.3 and 34.6, respectively. In addition, during these years, the

incidence of V-B per 100000 children aged 0-4 years was 20.0 and 38.4,

respectively. It has been decided that vaccination against VH-B will be

obligatory for all newborns beginning from 1993. Due to financial

constraints, it has been introduced in three phases, and since 1996, all

newborns in Poland have been vaccinated. Already in 1993, three additional

risk groups have been offered vaccination: patients with chronic diseases,

patients awaiting planned surgery, and persons coming into close contact

with acute VH-B or chronically HBV-infected individuals. In 1999, the

incidence of VH-B per 100000 was 9.1/100000, and it may be assumed that

vaccination helped to decrease the incidence of VH-B in Poland. The country

experience with vaccination against VH-A is still limited. At present, it is

recommended for children and adolescents and people dealing with food

distribution, as well as for several other groups of people, such as

travellers or long-term visitors (soldiers, missionaries, diplomats) to the

endemic regions of the world. It has also been recommended in connection

with natural disasters such as floods occurring in a large area of Poland in

1997.

PMID: 11257365, UI: 21157746

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