COMMENTARY

Speaking of Hepatitis, We Have 'A' Vaccine

William F. Balistreri, MD

Disclosures

July 12, 2013

In This Article

What Is the Rate of Compliance With Current Recommendations for Hepatitis A Vaccination?

The Centers for Disease Control and Prevention recently reported that 52% of children aged 19-35 months born between January 2008 and May 2010 had received the recommended ≥ 2 doses of the hepatitis A vaccine.[6] Another recent report evaluated adolescent hepatitis A vaccine coverage in the United States using provider-reported vaccination data.[12] In 2009, national 1-dose hepatitis A vaccine coverage among adolescents was 42%; overall, only 30% had received 2 doses. The adjusted prevalence ratios for vaccination initiation were highest for states with a vaccination requirement and for adolescents whose providers recommended the hepatitis A vaccine. Low coverage among most adolescents in the United States in 2009 renders a large population susceptible to HAV infection as they mature into adulthood.

Compliance Among High-Risk Groups

Since 1996, hepatitis A vaccine has been recommended for adults at increased risk for infection, including travelers to intermediate or high hepatitis A endemic countries. In 2009, travel outside the United States and Canada was the most common exposure reported for persons with HAV infection. Lu and colleagues[7] analyzed data from the 2010 National Health Interview Survey to determine self-reported hepatitis A vaccination coverage among adults who traveled to a country of intermediate or high HAV endemicity.[6] In 2010, 37% of adults reported traveling to endemic countries; among this group, vaccination coverage was 27% compared with 13% among nontravelers. They concluded that during patient encounters, healthcare providers should inquire about upcoming travel plans and recommend travel-related vaccinations. Furthermore, despite recommendations to vaccinate against HAV in patients with chronic hepatitis C infection, physicians often do not test or vaccinate susceptible individuals.[3] Interventions are needed to overcome the barriers identified and improve vaccination rates.

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