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. 2020 Jul 3;69(5):1-38.
doi: 10.15585/mmwr.rr6905a1.

Prevention of Hepatitis A Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices, 2020

Noele P Nelson, Mark K Weng, Megan G Hofmeister, Kelly L Moore, Mona Doshani, Saleem Kamili, Alaya Koneru, Penina Haber, Liesl Hagan, José R Romero, Sarah Schillie, Aaron M Harris

Prevention of Hepatitis A Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices, 2020

Noele P Nelson et al. MMWR Recomm Rep. .

Erratum in

  • Erratum: Vol. 69, No. RR-5.
    [No authors listed] [No authors listed] MMWR Morb Mortal Wkly Rep. 2021 Feb 26;70(8):294. doi: 10.15585/mmwr.mm7008a5. MMWR Morb Mortal Wkly Rep. 2021. PMID: 33630821 Free PMC article. No abstract available.

Abstract

HEPATITIS A IS A VACCINE-PREVENTABLE, COMMUNICABLE DISEASE OF THE LIVER CAUSED BY THE HEPATITIS A VIRUS (HAV). 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 AN ACUTE, SELF-LIMITED DISEASE THAT DOES NOT RESULT IN CHRONIC INFECTION. HAV ANTIBODIES (IMMUNOGLOBULIN G [IGG] 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. 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. 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. 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. THESE RECOMMENDATIONS ALSO PROVIDE GUIDANCE FOR VACCINATION BEFORE TRAVEL, FOR POSTEXPOSURE PROPHYLAXIS, IN SETTINGS PROVIDING SERVICES TO ADULTS, AND DURING OUTBREAKS.

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Conflict of interest statement

All 2019 Advisory Committee on Immunization Practices Hepatitis Vaccines Work Group members have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. Dr. Kelly L. Moore reports personal fees from Prime, Inc., and from Pfizer, outside the submitted work. The remaining members have no financial or competing interests with the manufacturers of commercial products or suppliers of commercial services related to hepatitis A (HepA) vaccines. Content will not include any discussion of the unlabeled use of a product or a product under investigational use, with the following exception: administration of HepA vaccine to infants aged 6–11 months traveling outside the United States when protection against HAV is recommended.

Figures

FIGURE 1
FIGURE 1
Number of reported and estimated hepatitis A cases — United States, 2013–2017 Source: CDC, National Notifiable Diseases Surveillance System. Surveillance for viral hepatitis—United States, 2017. Atlanta, GA: CDC, US Department of Health and Human Services. https://www.cdc.gov/hepatitis/statistics/2017surveillance/index.htm
FIGURE 2
FIGURE 2
Immunologic and clinical events associated with hepatitis A virus infection and recovery Source: CDC. Diagnosis and management of foodborne illnesses. MMWR Recomm Rep 2004;53(No. RR-4). Abbreviations: ALT = alanine aminotransferase; HAV = hepatitis A virus; IgG = immunoglobulin G; IgM = immunoglobulin M.
FIGURE 3
FIGURE 3
Estimated age at midpoint of population immunity to hepatitis A, by country — 2015 Source: Jacobsen KH. Globalization and the changing epidemiology of hepatitis A virus. Cold Spring Harb Perspect Med 2018;8:a031716. Abbreviations: AMPI = age at midpoint of population immunity; HAV = hepatitis A virus. * The AMPI is the youngest age at which half of the birth cohort has serologic evidence of previous exposure to HAV. As the AMPI increases (light to dark), the endemicity level of hepatitis A generally decreases.
See this image and copyright information in PMC

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