![]() ![]() This report supplants and summarizes previously published recommendations from ACIP for the prevention of HAV infection in the United States. Low adult HepA vaccination coverage and high population susceptibility to HAV infection allow outbreaks to continue to occur ( 13, 14). 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 ( 12). Small increases in cases occurred in 20 attributed to foodborne outbreaks associated with contaminated food ( 10, 11). These recommendations resulted in a 95.5% decrease in reported hepatitis A cases during 1996–2011 ( 9). In 2006, ACIP recommended routine HepA vaccination of all children aged 12–23 months ( 8). ![]() In 1999, ACIP expanded the recommendations to include routine vaccination for the following groups: 1) children aged ≥2 years in 11 states (Alaska, Arizona, California, Idaho, Nevada, New Mexico, Oklahoma, Oregon, South Dakota, Utah, and Washington) with average incidence rates that were at least twice the national average during 1987–1997 (i.e., ≥20 cases per 100,000 population) and 2) consideration of routine vaccination of children aged ≥2 years in six states (Arkansas, Colorado, Missouri, Montana, Texas, and Wyoming) where average incidence rates were greater than, but less than twice, the national average (i.e., ≥10 but <20 cases per 100,000 population) ( 7). ![]() In 1996, the Advisory Committee on Immunization Practices (ACIP) recommended routine vaccination of children aged ≥2 years who lived in communities with high rates of HAV infection, for populations at increased risk for HAV infection or the adverse consequences of infection, and in outbreak settings ( 6). Recommendations for hepatitis A (HepA) vaccine were introduced incrementally in the United States. Infection with HAV has not been found to cause chronic infection, although prolonged or relapsing hepatitis A has been reported ( 5). Disease severity increases in persons who are older or immunocompromised, have chronic liver disease, or have other underlying health conditions ( 2– 4). HAV infection is clinically indistinguishable from other types of acute viral hepatitis, and the illness is usually mild and self-limited when healthy persons are infected ( 1, 2). 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 ( 1, 2). These recommendations also provide guidance for vaccination before travel, for postexposure prophylaxis, in settings providing services to adults, and during outbreaks. ACIP recommends HepA vaccination for adults at risk for HAV infection or severe disease from HAV infection and for adults requesting protection against HAV without acknowledgment of a risk factor. ACIP recommends routine vaccination of children aged 12–23 months and catch-up vaccination for children and adolescents aged 2–18 years who have not previously received hepatitis A (HepA) vaccine at any age. ![]() This report supplants and summarizes previously published recommendations from the Advisory Committee on Immunization Practices (ACIP) regarding the prevention of HAV infection in the United States. HAV antibodies (immunoglobulin G anti-HAV) produced in response to HAV infection persist for life and protect against reinfection IgG anti-HAV produced after vaccination confer long-term immunity. Hepatitis A is an acute, self-limited disease that does not result in chronic infection. The infection is transmitted via the fecal-oral route, usually from direct person-to-person contact or consumption of contaminated food or water. Hepatitis A is a vaccine-preventable, communicable disease of the liver caused by the hepatitis A virus (HAV). ![]()
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