On June 27, the Advisory Committee on Immunization Practices (ACIP), part of the Centers for Disease Control and Prevention (CDC), unanimously agreed that children and teenagers ages 2 to 18 years should be vaccinated against hepatitis A virus (HAV) if they did not receive the vaccine as infants. The expert panel also recommended HAV vaccination for people living with HIV.
Hepatitis A is usually spread through food or water contaminated by feces or through person-to-person contact, including sexual contact. Unlike hepatitis B and C, most people infected with hepatitis A clear the virus naturally and become immune to reinfection. But in some cases, it can cause severe liver inflammation, liver failure and death.
Following a steep decline after the first HAV vaccine was approved in 1995, hepatitis A incidence has surged in the United States in recent years, including outbreaks among homeless people in several states.
Sine 2006, ACIP has recommended routine HAV vaccination for children between ages 1 and 2. The decision last week adds a recommendation for catch-up vaccination for those up to age 18 who were not previously immunized.
The new recommendation for vaccination of people living with HIV applies to those ages 1 and older. Studies show that HIV-positive people may take longer to recover from hepatitis A and may be more likely to develop liver complications. People with chronic liver diseases, including hepatitis B or C, are also more likely to develop complications from HAV.
ACIP also recommends vaccination for people at increased risk for hepatitis A, including travelers to areas where HAV is endemic (common within the population), people in close contact with adopted children from these areas, men who have sex with men, people who use drugs, people with chronic liver disease and those who could be exposed to HAV in an occupational setting. Last October, ACIP recommended hepatitis A vaccination for all homeless people.
Approved HAV vaccines include GlaxoSmithKline’s Havrix and Merck’s Vaqta. GSK also makes a combination hepatitis A and B vaccine called Twinrix. Havrix and Vaqta require two doses administered six to 18 months apart; Twinrix requires three doses.
The new HAV vaccine recommendations will become official when they are published in the CDC’s Morbidity and Mortality Weekly Report.
Click here to learn more about hepatitis A.