RESUMO: Introdução: Em 2014, o Brasil introduziu programa de imunização universal contra o vírus da hepatite A (HAV) para crianças no segundo ano de vida, por meio de dose única da vacina de vírus inativado. Este estudo teve como objetivo avaliar a cobertura vacinal (CV) contra o HAV no Brasil, diante da incidência de casos notificados cinco anos após a implantação do programa. Metodologia: Dados secundários foram obtidos pesquisando-se sítios eletrônicos de acesso livre do Ministério da Saúde, Departamento de Informática do Sistema Único de Saúde (DATASUS), para análise de incidência e CV. Resultados: A CV variou entre 60,13 e 97,07%. A homogeneidade da CV contra hepatite A nos estados ficou aquém da meta estabelecida. Após 2015, houve queda da CV em todas as regiões do país. Apesar da cobertura insuficiente, houve redução concomitante da incidência da hepatite A em todo o Brasil. A taxa de incidência caiu de 3,29 para 0,80/100 mil entre 2014 e 2018. No entanto, ocorreu diminuição da velocidade de queda da incidência entre 2017 e 2018, o que pode ser consequência dos percentuais insuficientes de CV. Esse fenômeno parece acompanhar tendência geral de enfraquecimento do esforço vacinal no país, verificado também para outras vacinas, como poliomielite e tríplice viral. Conclusão: Esses números sugerem a necessidade de esforços para melhorar as taxas de CV da hepatite A no país.

ABSTRACT: Introduction: In 2014, Brazil introduced a universal immunization program against the hepatitis A virus (HAV) for children in the second year of life, using a single dose of inactivated virus vaccine. The objective of this study was to evaluate the vaccination coverage (VC) against HAV in Brazil, against the incidence of cases reported five years after the implementation of the program. Methodology: Secondary data were obtained by searching free access electronic sites of the Ministry of Health, Department of Informatics of the Unified Health System (Departamento de Informática do Sistema Único de Saúde - DATASUS), for incidence analysis and VC from 2014 to 2018. Results: VC ranged from 60.13 to 97.07%. The homogeneity of VC against hepatitis A did not reach the established goal throughout all states but for a few exceptions. After 2015, CV decreased in all regions of the country. Despite insufficient coverage, a concomitant reduction in the incidence of Hepatitis A took place throughout the country. The incidence rate fell from 3.29 to 0.80/100,000 between 2014 and 2018. However, there was an interruption in the pace of incidence fall between 2017 and 2018, which may be a consequence of insufficient VC. This phenomenon seems to be part of a widespread downward trend in vaccination effort across the country, also verified for other vaccines, such as poliomyelitis and measles, mumps and rubella vaccine. Conclusion: These figures suggest the need for implementing efforts to improve hepatitis A VC rates in the country.

RESUMO: Introdução: Em 2014, o Brasil introduziu programa de imunização universal contra o vírus da hepatite A (HAV) para crianças no segundo ano de vida, por meio de dose única da vacina de vírus inativado. Este estudo teve como objetivo avaliar a cobertura vacinal (CV) contra o HAV no Brasil, diante da incidência de casos notificados cinco anos após a implantação do programa. Metodologia: Dados secundários foram obtidos pesquisando-se sítios eletrônicos de acesso livre do Ministério da Saúde, Departamento de Informática do Sistema Único de Saúde (DATASUS), para análise de incidência e CV. Resultados: A CV variou entre 60,13 e 97,07%. A homogeneidade da CV contra hepatite A nos estados ficou aquém da meta estabelecida. Após 2015, houve queda da CV em todas as regiões do país. Apesar da cobertura insuficiente, houve redução concomitante da incidência da hepatite A em todo o Brasil. A taxa de incidência caiu de 3,29 para 0,80/100 mil entre 2014 e 2018. No entanto, ocorreu diminuição da velocidade de queda da incidência entre 2017 e 2018, o que pode ser consequência dos percentuais insuficientes de CV. Esse fenômeno parece acompanhar tendência geral de enfraquecimento do esforço vacinal no país, verificado também para outras vacinas, como poliomielite e tríplice viral. Conclusão: Esses números sugerem a necessidade de esforços para melhorar as taxas de CV da hepatite A no país.

ABSTRACT: Introduction: In 2014, Brazil introduced a universal immunization program against the hepatitis A virus (HAV) for children in the second year of life, using a single dose of inactivated virus vaccine. The objective of this study was to evaluate the vaccination coverage (VC) against HAV in Brazil, against the incidence of cases reported five years after the implementation of the program. Methodology: Secondary data were obtained by searching free access electronic sites of the Ministry of Health, Department of Informatics of the Unified Health System (Departamento de Informática do Sistema Único de Saúde - DATASUS), for incidence analysis and VC from 2014 to 2018. Results: VC ranged from 60.13 to 97.07%. The homogeneity of VC against hepatitis A did not reach the established goal throughout all states but for a few exceptions. After 2015, CV decreased in all regions of the country. Despite insufficient coverage, a concomitant reduction in the incidence of Hepatitis A took place throughout the country. The incidence rate fell from 3.29 to 0.80/100,000 between 2014 and 2018. However, there was an interruption in the pace of incidence fall between 2017 and 2018, which may be a consequence of insufficient VC. This phenomenon seems to be part of a widespread downward trend in vaccination effort across the country, also verified for other vaccines, such as poliomyelitis and measles, mumps and rubella vaccine. Conclusion: These figures suggest the need for implementing efforts to improve hepatitis A VC rates in the country.

ABSTRACT Vaccination against the hepatitis A virus (HAV) administered in two doses has been used effectively in universal child immunization programs in several countries. A single-dose vaccination was adopted in some low-income countries in an attempt to reduce costs without losing effectiveness. In 2014, single-dose universal vaccination was introduced in Brazil for children aged two years. Since such strategy is still not universally accepted, its efficacy should be compared to the two-dose strategy. To assess the humoral response after the single-dose HAV vaccination schedule, a cross-sectional study was conducted in Primavera do Leste, in Mato Grosso state, Central Brazil, including 265 children vaccinated through the National Immunization Program. Blood was collected by using a digital puncture and further applied to filter paper cards. Anti-HAV was detected in 218 out of 265 dried blood spots (DBS). Blood venous samples were collected from 34 out of 47 children who were not anti-HAV positive in DBS samples. Eighteen of them tested positive for anti-HAV, giving a final score of 93.6% (236/252) of seropositivity. In conclusion, this study demonstrated a high rate of anti-HAV positivity in the short term after single-dose hepatitis A vaccination in the population investigated. Moreover, the DBS was shown to be a reliable tool for detecting anti-HAV antibodies.