The utilisation of hepatitis A vaccine 1992-1994

To assess the utilisation of hepatitis A vaccine in Scotland since it was licensed and also any impact this had on the utilisation of immunoglobulin prophylaxis.

Collation and analysis of information obtained from the Pharmacy Practice Division and the Scottish National Blood Transfusion Service (SNBTS).

Scotland. 1992 to 1994 inclusive.

All supplies/persons for whom hepatitis A vaccine or Human normal immunoglobulin (commercial or via SNBTS) was prescribed or dispensed in Scotland 1992-94.

Hepatitis A vaccine started to be utilised very shortly after it became available. Utilisation has increased progressively since April 1992 with nearly 65,000 "courses' being prescribed in 1994. There has been no obvious impact on the use of immunoglobulin which has increased during this period. New formulations of the vaccine, e.g. paediatric and one dose courses have been rapidly assimilated by practitioners into their practice. Both vaccine and immunoglobulin utilisation follow a marked seasonal pattern with a peak every June.

Statistics from the Pharmacy Practice Division proved useful in monitoring utilisation of this prescribed vaccine. The increasing utilisation of hepatitis A vaccine is a significant financial outlay for the NHS in Scotland. There may be significant non-compliance with the recommendations for restricting its use. The cost effectiveness of this immunisation for travellers has been recently called in question. The changing epidemiology of endemic infection is referred to in respect of possible immunisation programmes and the likely decline in efficacy of immunoglobulin. The need for more research on the incidence of hepatitis A antibody in the Scottish population is highlighted.