ArticlePloS one2015
Considerations on the current universal vaccination policy against hepatitis A in Greece after recent outbreaks.
Article in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 36 citations in OpenAlex.
- Impact of universal mass vaccination with monovalent inactivated hepatitis A vaccines - A systematic review.Human vaccines & immunotherapeutics · 2017Pooled it
- The 7 C Vaccination Readiness Scale: An Empirical Country Comparison Between Germany and Greece.Journal of epidemiology and global health · 2025Article
- Long-Term Surveillance of Food Products of Diverse Origins: A Five-Year Survey of Hepatitis A and Norovirus in Greece, 2019-2024.Pathogens (Basel, Switzerland) · 2025Article
- Article
- The global trends and regional differences in incidence and mortality of hepatitis A from 1990 to 2019 and implications for its prevention.Hepatology international · 2021Article
- Hepatitis A vaccination and its immunological and epidemiological long-term effects - a review of the evidence.Human vaccines & immunotherapeutics · 2021Review
- Hepatotropic viruses: Is Roma population at risk?World journal of gastroenterology · 2021Review
- Epidemiology of hepatitis A in Greece in the last decade: management of reported cases and outbreaks and lessons learned.Epidemiology and infection · 2020Article
- Hepatitis A virus infections, immunisations and demographic determinants in children and adolescents, Germany.Scientific reports · 2018Article
- Hepatitis A virus infections and outbreaks in asylum seekers arriving to Germany, September 2015 to March 2016.Emerging microbes & infections · 2017Article
- Low vaccination coverage of Greek Roma children amid economic crisis: national survey using stratified cluster sampling.European journal of public health · 2017Article
- Hepatitis A among refugees, asylum seekers and migrants living in hosting facilities, Greece, April to December 2016.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2017Article
- A cross-sectional vaccination coverage study in preschool children attending nurseries-kindergartens: Implications on economic crisis effect.Human vaccines & immunotherapeutics · 2017Article
- Article
- A large ongoing outbreak of hepatitis A predominantly affecting young males in Lazio, Italy; August 2016 - March 2017.PloS one · 2017Article
- Time trends in pediatric hospitalizations for hepatitis A in Greece (1999-2013): Assessment of the impact of universal infant immunization in 2008.Human vaccines & immunotherapeutics · 2016Article
- The Syrian refugees crisis brings challenges to the health authorities in Europe: hepatitis A virus is a case in point.European journal of epidemiology · 2016Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Greece is the only European Union member state that in 2008 included hepatitis A (HAV) vaccine in the routine national childhood immunization program (NCIP). Given that the resources allocated to public health have dramatically decreased since 2008 and that Greece is a low endemicity country for the disease, the benefit from universal vaccination has been questioned. The aim of this paper is to summarize the available epidemiological data of the disease for 1982-2013, and discuss the effects of universal vaccination on disease morbidity. Descriptive analysis, ARIMA modeling and time series intervention analysis were conducted using surveillance data of acute HAV. A decreasing trend of HAV notification rate over the years was identified (p<0.001). However, universal vaccination (~ 80% vaccine coverage of children) had no significant effect on the annual number of reported cases (p = 0.261) and has resulted to a progressive increase of the average age of infection in the general population. The mean age of cases before the inclusion of the vaccine to NCIP (24.1 years, SD = 1.5) was significantly lower than the mean age of cases after 2008 (31.7 years, SD = 2.1) (p<0.001). In the last decade, one third of all reported cases were Roma (a population accounting for 1.5% of the country's total population) and in 2013 three outbreaks with 16, 9 and 25 Roma cases respectively, were recorded, indicating the decreased effectiveness of the current immunization strategy in this group. Data suggest that universal vaccination may need to be re-considered. Probably a more cost effective approach would be to implement a program that will include: a) vaccination of high risk groups, b) universal vaccination of Roma children and improving conditions at Roma camps, c) education of the population and travel advice, and d) enhancement of the control measures to increase safety of shellfish and other foods.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.