Background: In Canada -a low endemicity country, vaccines for hepatitis A virus (HAV) are currently recommended to individuals at increased risk for infection or its complications. Applying these recommendations is difficult because the epidemiology of HAV infection is poorly defined, complex, and changing. This systematic review aimed to 1) estimate age-specific prevalence of HAV antibody in Canada and 2) evaluate infection-associated risk factors.

The risk for hepatitis A during childhood is low in Canada. Almost all teenagers (>97%) would be at risk for infection in case of contact with HAV. Changes in immunization policy against hepatitis A should be considered.

Study population was susceptible to ST11 complex meningococci bearing both C and W135 polysaccharide capsules; vaccine against serogroup C meningococci may not prevent ST11 disease.

This preschool DTaP.IPV booster vaccination caused large local reactions in 1 in 5 children, with transient discomfort. With Tdap vaccine, such reactions were significantly fewer but not eliminated. A Tdap.IPV vaccine warrants study for routine use at 4-6 years of age.