The European Society of Clinical Microbiology and Infectious Diseases (ESCMID) has published an opinion paper on vaccination against the hepatitis E (VHE) virus. Experts make a review of existing clinical data and issues recommendations on the implementation strategies of vaccine programs.
While the virus is responsible for some 100 million infections, 70,000 deaths and 3,000 mortinities each year, ESCMID pleads in favor of routine vaccination within risky populations against the VHE. A position that goes against the World Health Organization which recommends a vaccination only during epidemic outbreaks. The argument is published in the Journal de l’Escmid, Clinical Microbiology and Infection.
Long -term efficiency of Chinese vaccine
Acute VHE infection poses severe risk of liver failure for pregnant women and patients with preexisting liver disease. Chronic infection can cause complications in immunocompromised people and transplanted patients, which can progress towards advanced hepatic fibrosis or cirrhosis.
The literature review looks at the HEV 239 vaccine, authorized and marketed only in China since 2012, under the name Hecolin, the only one available worldwide. “Several studies have demonstrated the strong immunogenicity of the HEV 239 vaccine with excellent seroconversion rates through various clinical trials”we read in the article. According to one of the trials, conducted on nearly 100,000 participants from 16 to 65 years old, the seroconversion rate is maintained in the long term: 100 % to 1 year, 93 % at 4.5 years and 87 % after 10 years.
-Do not vaccinate either too early or too late
With regard to these encouraging results, ESCMID is positioned in favor of the inclusion of VHE vaccination in immunization programs by targeting populations at risk: women of childbearing age, patients with chronic liver disease, before a Immunosuppression for patients exposed to genotypes 3 and 4 (circulating in industrialized countries). The European company highlights the importance of the vaccination calendar: not too late to ensure that adolescent girls receive protection against the virus before pregnancy, but not too early to prevent immunization from decreasing.
“VOHE vaccination has real potential as a public health tool, but several factors must be addressed”defend experts, suggesting to conduct clinical trials to attest to the efficiency and safety of the vaccine among European populations and to assess the cost-effectiveness report according to the prevalence of the virus in the region. The authors recommend strengthening the diagnostic sector by improving surveillance systems with robust tools and inviting Europe to finance research in the diagnosis and control of the VHE.
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