Prevention of hepatitis A by vaccination.

Inactivated hepatitis A vaccines have been available for more than a decade. Characteristics of the vaccines, comparative data among different formulations and the possibility of combination and association with other vaccines are reviewed in this article. Hepatitis A vaccines show high immunogenicity with different schedules and associations, induce long-term protection irrespective of timing of booster dose, and present an excellent safety profile. Pre-exposure efficacy has been demonstrated in large trials and postexposure protection has been described in family contacts of acute cases. The recommendations for the use of hepatitis A vaccines for immunisation campaigns and for targeted groups, such as travellers and people at risk for occupational and iatrogenic exposure or lifestyle behaviours, are discussed. Aspects related to economic analysis of vaccination strategies are also considered.