We present the consensus document on the immunization schedule for adolescents developed by 3 scientific societies: the Spanish Association of Pediatrics (AEP), through its Advisory Committee on Vaccines (CAV-AEP), the Spanish Society of Adolescent Medicine (SEMA) and the Spanish Association of Vaccinology (AEV). There are particularities in infectious disease during adolescence, such as an increased susceptibility to pertussis, poorer outcomes of chickenpox, mumps and hepatitis A, a high incidence of sexually transmitted infections or increased prevalence of meningococcal carriage. The document analyses the schedule for adolescents in the context of vaccination policy overall. It contemplates the vaccines to be included in the immunization schedule for healthy adolescents: against invasive meningococcal disease (tetravalent ACWY and B), against human papillomavirus (which should be gender-neutral), against pertussis, against influenza and against SARS-CoV-2 (in unvaccinated individuals and at-risk groups). It is worth noting that the 4CMenB vaccine appears to confer some protection against gonococcal infection, which would be a considerable added value for adolescents. The vaccination of adolescents belonging to risk groups or travelling abroad also needs to be contemplated, as is the case in any other age group. Vaccination against hepatitis A, which is included in the routine immunization schedule of Catalonia, Ceuta and Melilla from the second year of life, should also be considered a priority in adolescents traveling to endemic areas.

In China, the incidence rate of Hepatitis A has decreased from 56/100 000 in 1991 to 1.05/100 000 in 2020. The number of Hepatitis A outbreaks in China has decreased significantly, however, it has also happened in the last 5 years, and the risk still remains. In order to strengthen the technical guidance for the investigation and control of Hepatitis A outbreak, the Chinese Center for Disease Control and Prevention (China CDC) organized experts in related fields to compile this guideline. The main contents included outbreak definition, outbreak detecting and reporting, outbreak investigation and response, making conclusion and communication. This guideline is intended for use by staff at public health administrative departments, medical and health institutions, centers for disease control and prevention, health supervision agencies at different levels, and other relevant institutions, units and individuals. China CDC will update this guideline periodically based on the progress in this field and feedbacks during the implementation of this guideline.
我国甲型肝炎报告发病率从1991年的56/10万下降到2020年的1.05/10万，甲型肝炎暴发数量较以前明显减少，但近5年也时有报道，仍存在风险。为加强对全国甲型肝炎暴发疫情调查处置和预防控制工作的技术指导，中国疾病预防控制中心组织相关领域专家，联合编写了本指南。本指南包括甲型肝炎暴发的监测和定义，甲型肝炎疫情的识别和报告，暴发疫情的规范调查和处置原则、调查结果的交流与反馈等。本指南适用于各级卫生行政部门、医疗保健机构、疾病预防控制机构、卫生监督机构以及相关集体、单位和个人。中国疾病预防控制中心将根据指南执行过程中反馈的问题和学科进展定期对指南进行修订。.

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BACKGROUND: This Dutch travel Vaccination Study (DiVeST) aimed to study adherence or compliance to Dutch travel health guidelines in travelling families and to identify risk groups to provide better advice and protection for international travellers.
METHODS: Between 2016 and 2018, family members who travelled to Eastern Europe or outside Europe during the preceding year were recruited via Dutch secondary schools. The vaccination status of the travellers was assessed using questionnaires and vaccination records and hepatitis A virus antibody concentrations in dried blood spot (DBS) eluates. Subgroups of travellers with lower adherence to guidelines were identified.
RESULTS: Of the 246 travellers that participated in this study, 155 (63%) travelled to destinations for which the HAV vaccination was recommended. Of these 155 travellers, 56 (36%) said they visited a pre-travel clinic, and 64 of them (41%) showed a valid HAV vaccination in their vaccination records. Of the 145 travellers with available DBS eluates, anti-HAV antibodies were detected in 98 (68%) of them.
CONCLUSIONS: We found that adherence to travel health guidelines, in terms of HAV vaccination, was suboptimal. According to our results, specific attention should be paid to children, persons visiting friends and relatives and those who travel relatively short distances.

Laboratory surveillance plays an important role in the detection and control of hepatitis A outbreaks and requires the application of rapid and accurate molecular diagnostic tools for hepatitis A virus (HAV) RNA detection, subgenotype identification, and sequence-based genotyping. We describe the development and validation of a triplex real-time, reverse transcription-PCR (triplex rRT-PCR) assay for the identification and discrimination of HAV subgenotypes IA, IB, and IIIA and a singleplex rRT-PCR assay designed to detect all HAV genotypes infecting humans. Overall, the accuracy, sensitivity, and specificity of the new assays were >97% for serum and plasma specimens collected during unrelated outbreaks of HAV in California and Michigan compared to a nested RT-PCR genotyping assay and the ISO 15216-1 rRT-PCR method for HAV detection. The new assays will permit the rapid detection of HAV RNA and discrimination among subgenotypes IA, IB, and IIIA in serum and plasma specimens, which will strengthen public health surveillance efforts for HAV outbreak detection and response.

BACKGROUND: In 2009, national guidelines for hepatitis A control in Australia changed to recommend hepatitis A vaccine (HAV), instead of normal human immune globulin (NHIG), for post-exposure prophylaxis (PEP).
OBJECTIVE: (1) Determine whether the uptake of PEP among contacts of hepatitis A cases changed after the introduction of the new guidelines, and (2) assess the field effectiveness of the HAV used as PEP in preventing infection among contacts of hepatitis A cases.
METHODS: A retrospective cohort of contacts from hepatitis A cases reported to metropolitan Public Health Units in Sydney, Australia, between October 2008 and June 2010, was identified. Contacts were analysed by time period, age, PEP type, and susceptibility to hepatitis A. The relative risk (RR) of hepatitis A infection among susceptible contacts who received HAV, compared with susceptible contacts who had not received HAV, was calculated to estimate the effectiveness of the HAV when used as PEP.
RESULTS: The uptake of PEP by susceptible contacts increased from 76% (n=133) to 89% (n=127) after the introduction of the new guidelines. Before the change in guidelines, no one who received PEP was later reported with hepatitis A. After the change in guidelines, one of the 123 contacts who received HAV as PEP was subsequently reported with hepatitis A. However, this case was likely to have been co-exposed with a primary case. Conservatively, assuming this was a secondary case, the vaccine effectiveness of HAV was 95.6% (66.1%-99.4%). Nine of 10 incident cases of hepatitis A were contacts who did not receive any PEP.
CONCLUSIONS: The improved uptake of PEP and the high estimate of the effectiveness of HAV provides support for using HAV for PEP. The very high occurrence of hepatitis A among contacts who did not receive any PEP further highlights the importance of PEP in preventing hepatitis A infection.

While gay and bisexual men should be vaccinated according to the most recent guidelines, this population also has needs that extend beyond those guidelines. This article explores current vaccination recommendations for gay and bisexual men and provides strategies to reduce barriers to vaccination in this population.

OBJECTIVE: Hepatitis A (HAV) and hepatitis B (HBV) vaccination in patients with chronic liver disease is an accepted standard of care. We determined HAV and HBV vaccination rates in a tertiary care referral hepatology clinic and the impact of electronic health record (EHR)-based reminders on adherence to vaccination guidelines.
METHODS: We reviewed the records of 705 patients with chronic liver disease referred to our liver clinic in 2008 with at least two follow-up visits during the subsequent year. Demographics, referral source, etiology, and hepatitis serology were recorded. We determined whether eligible patients were offered vaccination and whether patients received vaccination. Barriers to vaccination were determined by a follow-up telephone interview.
RESULTS: HAV and HBV serologic testing prior to referral and at the liver clinic were performed in 14.5% and 17.7%; and 76.7% and 74% patients, respectively. Hepatologists recommended vaccination for HAV in 63% and for HBV in 59.7% of eligible patients. Patient demographics or disease etiology did not influence recommendation rates. Significant variability was observed in vaccination recommendation amongst individual providers (30-98.6%), which did not correlate with the number of patients seen by each physician. Vaccination recommendation rates were not different for Medicare patients with hepatitis C infection for whom a vaccination reminder was automatically generated by the EHR. Most patients who failed to get vaccination after recommendation offered no specific reason for noncompliance; insurance was a barrier in a minority.
CONCLUSIONS: Hepatitis vaccination rates were suboptimal even in an academic, sub-speciality setting, with wide-variability in provider adherence to vaccination guidelines.

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This survey was conducted in September 2001 to audit the practice of Consultants in Communicable Disease Control (CsCDC) and to gain a systematic picture of pre-guideline approaches to the control of hepatitis A virus infection in England and Wales. An audit form was distributed to all CsCDC by email and responses were entered in a database and analysed. Response rate is estimated at 44%. CsCDC predominantly recommend vaccination for prevention. For 31% of the CsCDC, index cases were not reported within a week of the onset of illness. As a result, vaccine was often used sub-optimally. By contrast 95% of the CsCDC were informed of an index case within two weeks of onset of illness, in time for effective use of human normal immunoglobulin (HNIG). CsCDC were cautious in the use of HNIG for a number of reasons including concerns about variant Creutzfeldt-Jacob Disease (vCJD). A substantial proportion (between 5% and 28% for different age groups) of CsCDC did not recommend any active prevention among close family contacts of a case. Important ways to improve practice include facilitating use of HNIG and speeding up reporting by doctors and laboratories.