Hepatitis A : FAQ, Part 3

by CDC

(Page 3 of 4)

Who Should Get Vaccinated Against Hepatitis A?

Hepatitis A vaccination provides protection before one is exposed to hepatitis A virus. Hepatitis A vaccination is recommended for the following groups who are at increased risk for infection and for any person wishing to obtain immunity.

Persons traveling to or working in countries that have high or intermediate rates of hepatitis A.

All susceptible persons traveling to or working in countries that have high or intermediate rates of hepatitis A should be vaccinated or receive immune globulin before traveling. Persons from developed countries who travel to developing countries are at high risk for hepatitis A. Such persons include tourists, military personnel, missionaries, and others who work or study abroad in countries that have high or intermediate levels of hepatitis A. The risk for hepatitis A exists even for travelers to urban areas, those who stay in luxury hotels, and those who report that they have good hygiene and that they are careful about what they drink and eat.

Children in states, counties, and communities where rates of hepatitis A were/are at least twice the national average during the baseline period of 1987-1997.

Children living in states, counties, and communities where rates of hepatitis A are at least twice the national average ( ≥ 20 cases/1000,000) in baseline period should be routinely vaccinated beginning at 12 months of age. High rates of hepatitis A have been found in these populations, both in urban and rural settings. In addition, to effectively prevent epidemics of hepatitis A, vaccination of previously unvaccinated older children is recommended within 5 years of initiation of routine childhood vaccination programs. Although rates differ among areas, available data indicate that a reasonable cutoff age in many areas is 10-15 years of age because older persons have often already had hepatitis A. Vaccination of children before they enter school should receive highest priority, followed by vaccination of older children who have not been vaccinated.

Men who have sex with men

Sexually active men (both adolescents and adults) who have sex with men should be vaccinated.

Hepatitis A outbreaks among men who have sex with men have been reported frequently. Recent outbreaks have occurred in urban areas in the United States, Canada, and Australia.

Illegal-drug users

Vaccination is recommended for injecting and non-injecting illegal-drug users.

Persons who have occupational risk for infection

Persons who work with hepatitis A virus-infected primates or with hepatitis A virus in a research laboratory setting should be vaccinated. No other groups have been shown to be at increased risk for hepatitis A virus infection because of occupational exposure.

Outbreaks of hepatitis A have been reported among persons working with non-human primates that are susceptible to hepatitis A virus infection, including several Old World and New World species. Primates that were infected were those that had been born in the wild, not those that had been born and raised in captivity.

Persons who have chronic liver disease

Persons with chronic liver disease who have never had hepatitis A should be vaccinated, as there is a higher rate of fulminant (rapid onset of liver failure, often leading to death) hepatitis A among persons with chronic liver disease. Persons who are either awaiting or have received liver transplants also should be vaccinated.

Persons who have clotting-factor disorders

Persons who have never had hepatitis A and who are administered clotting-factor concentrates, especially solvent detergent-treated preparations, should be given hepatitis A vaccine.

All persons with hemophilia (Factor VIII, Factor IX) who receive replacement therapy should be vaccinated because there appears to be an increased risk of transmission from clotting-factor concentrates that are not heat inactivated.

Which Groups Do Not Routinely Need Hepatitis A Vaccine?

Food service workers

Foodborne hepatitis A outbreaks are relatively uncommon in the United States; however, when they occur, intensive public health efforts are required for their control.

Although persons who work as food handlers have a critical role in common-source foodborne outbreaks, they are not at increased risk for hepatitis A because of their occupation. Consideration may be given to vaccination of employees who work in areas where community-wide outbreaks are occurring and where state and local health authorities or private employers determine that such vaccination is cost-effective.

About the Author

www.cdc.gov
The Centers for Disease Control and Prevention (CDC) is one of the 13 major operating components of the Department of Health and Human Services (HHS), which is the principal agency in the United States government for protecting the health and safety of all Americans and for providing essential human services, especially for those people who are least able to help themselves.