Injection

Prevention of Hepatitis A Virus Infection in the US: Recommendations of the ACIP

Jul 02, 2020 | Kimberly Sharpe-Scott

The CDC, in collaboration with the Advisory Committee on Immunization Practices (ACIP), published new recommendations for hepatitis A vaccination. The recently released MMWR, Prevention of Hepatitis A Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices, 2020, highlights the following key messages:

  • Hepatitis A vaccines were first recommended by ACIP in 1996 and the last full recommendations and report was published 14 years ago in 2006, when ACIP recommended routine hepatitis A vaccination of all children aged 12–23 months.
  • The hepatitis A virus (HAV) is transmitted via the fecal-oral route, usually through direct person-to-person contact or consumption of contaminated food or water.
  • Illness is usually mild and self-limited when healthy persons are infected, however disease severity increases in persons who are older or immunocompromised, have chronic liver disease, or have other underlying health conditions.
  • After the introduction of hepatitis A vaccination in 1996, reported hepatitis A cases fell over 95% between 1996 and 2011.
  • Since then small increases in cases occurred in 2013 and 2016 attributed to foodborne outbreaks associated with contaminated food; then, beginning in 2016, greater increases in the number of reported cases occurred across the United States, primarily from widespread outbreaks of hepatitis A from person-to-person transmission resulting in a sharp increase in cases from 2,007 in 2016 to 12,474 in 2018.
  • Low adult HepA vaccination coverage and high population susceptibility to HAV infection allow outbreaks to continue to occur.
  • These outbreaks have led the Advisory Committee on Immunization Practices to review the data on vaccination and prepare new hepatitis A recommendations to decrease HAV incidence and prevent future outbreaks.

The new and updated ACIP recommendations include, but are not limited to:

  • Vaccination of all children and adolescents aged 2–18 years who have not previously received HepA vaccine (catch-up vaccination)
  • Vaccination of all persons aged ≥1 year infected with human immunodeficiency virus (HIV)
  • Vaccination of pregnant women who are identified to be at risk for HAV infection during pregnancy or for having a severe outcome from HAV infection
  • Vaccination during hepatitis A outbreaks of persons aged ≥1 year who are at risk for HAV infection or who are at risk for severe disease from HAV
  • Vaccination in settings providing services to adults in which a high proportion of persons have risk factors for HAV infection (e.g., health care settings with a focus on those who use injection or non-injection drugs, group homes, and nonresidential day care facilities for developmentally disabled persons)

Access the recently released MMWR detailing updated hepatitis A vaccination recommendations here.


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