During a large community-wide outbreak of hepatitis A in two adjoining villages in Slovakia with a total of 5,000 inhabitants we administered to schoolchildren the first commercially available vaccine against hepatitis A (HAVRIX, Smith-Kline Beecham Biologicals, Rixensart, Belgium) in an attempt to control the progress of the epidemic. Soon after the start of the vaccination programme, an abrupt decrease in the occurrence of cases in the school was observed. In the village school with 624 schoolchildren, 404 had received a first dose of 360 enzyme-linked immunosorbent assay (ELISA) units (EL.U) and 373 a second dose 1 month later. Subsequent to the start of vaccination there were eight clinical cases of hepatitis A among the 157 children without a history of hepatitis A who remained unvaccinated and only 1 case in the vaccinated school children, giving attack rates of 5.1% and 0.25% in the two groups, respectively. Among the remaining 63 children, one was found seropositive when screened and 62 had a history of hepatitis A at the start of the vaccination programme. These 63 children were not offered vaccine. No cases occurred in that group. During the epidemic, three cases occurred an average of 20 days following its administration among 19 children who received immune globulin (IG). Cases in the whole population of the villages also ceased soon after the vaccination of the children had started. The vaccine was found more effective than postexposure IG in interrupting the epidemic in the whole community.

The immunogenicity of influenza vaccination in elderly institutionalized patients, with a variety of clinical disorders, was tested in an open multicenter study involving 495 people (mean age 80 years). Vaccination with an inactivated split influenza vaccine (Fluarix^TM) was clinically well tolerated. For all age ranges and all strains of virus, the vaccine elicited a humoral response which surpassed the European Community requirements for influenza vaccines in adults over 60 years. The geometric mean titers for all vaccine strains were significantly increased 28 days after vaccination, and remained higher than prevaccination levels after 6 months. These immunological parameters were unaffected by the clinical status of the patients.

the new diphtheria-tetanus-acellular pertussis-hepatitis B virus-inactivated polio/ Haemophilus influenzae b vaccine administered at 3, 5 and 11 months of age was safe and at least as immunogenic as the comparator vaccines thus providing an effective and more comfortable option for this infant vaccination schedule.

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SUMMARYTo help achieve universal infant immunisation against hepatitis B, the World Health Organisation has recommended the development of a combined diphtheria, tetanus and pertussis (DTP) and hepatitis B vaccine (HBV). The advantages come from the fact that DTP coverage is estimated to be over 80% worldwide and a combined DTP‐HB vaccine would increase the coverage of HBV. This study was conducted to compare the immunogenicity and reactogenicity of a combined DTP‐HB vaccine with separate, concomitant administration of DTP and HBV vaccines. One hundred and twenty infants were randomised in a 1:1 ratio to one of the two vaccination regimens, given as three injections at approximately 3, 4 and 5 months of age. The only difference in immunogenicity between the two regimens was a higher antibody response to hepatitis B in the group given the combined vaccine, possibly as a result of the adjuvant effect of the whole cell pertussis component of the DTP vaccine. Both vaccine regimens were well tolerated.