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Correctional settings provide a high-risk environment for hepatitis A transmission because of the high proportion of homelessness and injection drug use among persons who are incarcerated. On May 30, 2023, Los Angeles County Department of Public Health informed the Communicable Disease Surveillance and Control (CDSC) unit of the Los Angeles County Jail system that a symptomatic incarcerated person had received a positive test result for acute hepatitis A. Upon learning the next day that the patient was a food handler, CDSC staff members identified 5,830 potential contacts of the index patient, 1,702 of whom had been released from the jail. During June 1-12, a total of 2,766 contacts who did not have a documented history of hepatitis A serology or vaccination that could be confirmed from the electronic health record or state immunization registry were identified. These persons were offered hepatitis A vaccination as postexposure prophylaxis; 1,510 (54.6%) accepted vaccination. Contacts who were food handlers without confirmed evidence of immunity and who declined vaccination were removed from food-handling duties for the duration of their potential incubation period. No additional cases were identified. Identifying contacts promptly and using immunization and serology records to ensure rapid delivery of postexposure prophylactic vaccine can help prevent hepatitis A transmission during exposures among incarcerated populations. [ABSTRACT FROM AUTHOR]

National Immunization Survey-Child data collected in 2022 were combined with data from previous years to assemble birth cohorts and assess coverage with routine vaccines by age 24 months by birth cohort. Overall, vaccination coverage was similar among children born during 2019–2020 compared with children born during 2017–2018, except that coverage with both the birth dose of hepatitis B vaccine and ≥1 dose of hepatitis A vaccine increased. Coverage was generally higher among non-Hispanic White (White) children (2–21 percentage points higher than coverage for non-Hispanic Black or African American, Hispanic or Latino, and non-Hispanic American Indian/Alaska Native [AI/AN] children), children living at or above poverty (3.5–22 percentage points higher than coverage for children living below the federal poverty level), privately insured children (2.4–38 percentage points higher than coverage for children with Medicaid, other insurance, or no insurance), and children in urban areas (3–16.5 percentage points higher than coverage for children living in rural areas). Coverage with the full series of Haemophilus influenzae type b conjugate vaccine was lower among AI/AN children compared with White children. Trends in vaccination coverage disparities across categories of race and ethnicity, health insurance status, poverty status, and urbanicity were evaluated for the 2016–2020 birth cohorts. Fewer than 5% of 168 trends examined were statistically significant, including six increases (widening of the coverage gap) and one decrease (narrowing of the gap). Analyses revealed a widening of the gap between children living at or above the poverty level (higher coverage) and those living below poverty (lower coverage), for several vaccines. Socioeconomic, demographic, and geographic disparities in vaccination coverage persist; addressing them is important to ensure protection for all children against vaccinepreventable disease. [ABSTRACT FROM AUTHOR]

Hepatitis A (HepA) vaccination is recommended routinely for children at age 12-23 months, for persons who are at increased risk for hepatitis A virus (HAV) infection, and for any person wishing to obtain immunity. Persons at increased risk for HAV infection include international travelers to areas with high or intermediate hepatitis A endemicity, men who have sex with men, users of injection and noninjection drugs, persons with chronic liver disease, person with clotting factor disorders, persons who work with HAV-infected primates or with HAV in a research laboratory setting, and persons who anticipate close contact with an international adoptee from a country of high or interme-diate endemicity (1-3). Persons experiencing homelessness are also at higher risk for HAV infection and severe infection-associated outcomes. On October 24, 2018, the Advisory Committee on Immunization Practices (ACIP)* recommended that all persons aged 1 year and older experiencing homelessness be routinely immunized against HAV. The ACIP Hepatitis Vaccines Work Group conducted a systematic review of the evidence for administering vaccine to persons experiencing homelessness, which included a set of criteria assessing the benefits and adverse events associated with vaccination. HepA vaccines are highly immunogenic, and >95% of immunocompetent adults develop protective antibody within 4 weeks of receipt of 1 dose of the vaccine (1). HAV infections are acquired primarily by the fecal-oral route by either person-to-person transmission or via ingestion of contaminated food or water. Among persons experiencing homelessness, effective implementation of alternative strategies to prevent exposure to HAV, such as strict hand hygiene, is difficult because of living conditions among persons in this population. Integrating routine HepA vaccination into health care services for persons experiencing homelessness can reduce the size of the at-risk population over time and thereby reduce the risk for large-scale outbreaks. [ABSTRACT FROM AUTHOR]

Postexposure prophylaxis (PEP) with hepatitis A (HepA) vaccine or immune globulin (IG) effectively prevents infection with hepatitis A virus (HAV) when administered within 2 weeks of exposure. Preexposure prophylaxis against HAV infection through the administration of HepA vaccine or IG provides protection for unvaccinated persons traveling to or working in countries that have high or intermediate HAV endemicity. The Advisory Committee on Immunization Practices (ACIP) Hepatitis Vaccines Work Group conducted a systematic review of the evidence for administering vaccine for PEP to persons aged >40 years and reviewed the HepA vaccine efficacy and safety in infants and the benefits of protection against HAV before international travel. The February 21, 2018, ACIP recommendations update and supersede previous ACIP recommendations for HepA vaccine for PEP and for international travel. Current recommendations include that HepA vaccine should be administered to all persons aged ≥12 months for PEP. In addition to HepA vaccine, IG may be administered to persons aged >40 years depending on the provider's risk assessment. ACIP also recommended that HepA vaccine be administered to infants aged 6-11 months traveling outside the United States when protection against HAV is recommended. The travel-related dose for infants aged 6-11 months should not be counted toward the routine 2-dose series. The dosage of IG has been updated where applicable (0.1 mL/kg). HepA vaccine for PEP provides advantages over IG, including induction of active immunity, longer duration of protection, ease of administration, and greater acceptability and availability. [ABSTRACT FROM AUTHOR]

The article focuses on a report related to vaccination coverage among children of age between 19 to 35 months, at national, state and local area levels in the U.S., which is based on the National Immunization Survey of 2014. It states that changes in national vaccination coverage among the children were not prominent between 2013-2014 except from the Hepatitis A vaccination. It mentions that for coverage by geographic area highest level of coverage was reported for the MMR vaccine in Maine.

The article describes an investigation over the outbreak of hepatitis A virus infections in adult group homes (GHs) in southeast Michigan, challenges of timely delivery of postexposure prophylaxis (PEP) for hepatitis A and need for preexposure vaccination against hepatitis A for adults living or working in GH for adults. The outbreak stresses risk for HAV infection in adults living in small group settings for disabled and the need for a public health response that include hepatitis A vaccine.

The article reports on the adult immunization schedule in the U.S. for 2015 which was approved by the Advisory Committee on Immunization Practices (ACIP) in October 2014. Topics discussed include the criteria used in selecting adults for the schedule, the coverage for pneumococcal vaccination, and age of adults who are covered by tetanus vaccination. The coverage for hepatitis A, hepatitis B, herpes zoster and human papillomavirus (HPV) vaccinations is also discussed.

The article summarizes the results of an analysis of vaccination coverage among adults in the U.S. in 2012. The analysis covers tetanus, diphtheria and acellular pertussis vaccination and hepatitis A, hepatitis B, herpes zoster and human papillomavirus (HPV) vaccination. The results put pneumococcal vaccination coverage at 20 percent, hepatitis A vaccination coverage at 12.2 percent and HPV vaccination coverage at 34.5 percent.

The article reports on noninfluenza vaccination coverage among adults in the U.S. in 2011. It summarizes the results of an analysis for several vaccines, such as pneumococcal, hepatitis A, and herpes zoster, by selected characteristics. It also cites the use of weighted data to produce national estimates, as well as the use of statistical software to account for the complex sample design.

The article discusses vaccination coverage among U.S. adults in 2010 based on an analysis conducted by the Centers for Disease Control and Prevention (CDC). The analysis focused on pneumococcal, hepatitis A, hepatitis B, herpes zoster or shingles, human papillomavirus (HPV) vaccines and tetanus antigen-containing vaccines. The different age groups receiving selected vaccinations and the racial or ethnical differences in coverage for each vaccine are detailed.

The article discusses data gathered by the U.S. National Immunization Survey (NIS). The NIS data is used to study and watch childhood immunization coverage not only nation wide, but also at state and city wide levels. NIS data shows that in 2009, coverage increased for Hepatitis B and Hepatitus A, but decreased for Pneumococcal Conjugate Vaccine (PCV). The article also provides tables that show the estimated vaccination coverage among children in the U.S. and gives details on which vaccination increased and decreased.

The article assesses hepatitis A vaccine coverage among children aged 12-23 months from 2006 through 2009 in the U.S. using data from eight Immunization Information System (IIS) sentinel sites by the Centers for Disease Control and Prevention (CDC). The sites include Arizona, Colorado and Michigan. It says that from 2006 to the first quarter of 2007, coverage rose 5-10 percentage points. In 2007, the incidence of acute hepatitis A fell to the lowest level recorded.

The article reports an update on the findings on hepatitis A vaccination coverage among children between the ages of 24 to 35 months in the U.S. for 2006 and 2007. It references data from the National Immunization Survey (NIS). Findings were compared from the vaccination coverage since 1999. Also noted are observed differences in estimates of hepatitis A vaccination coverage among non-Hispanic whites, American Indian/Alaska Native and Asian children.

The article presents information on recommendations issued by the U.S. Advisory Committee on Immunization Practices for prevention of hepatitis A after exposure to hepatitis A virus (HAV) and in international travelers. The committee recommends hepatitis A vaccination of all children at age 12 to 23 months, catch-up vaccination of older children in selected areas and vaccination of persons at increased risk for hepatitis A. Also, all travelers are recommended to receive immune globulin before departure in order to prevent the risk for HAV infection.

The article reports on Hepatitis A vaccination coverage among U.S. children aged 24-35 months in 2004-2005. It found that the coverage increased from 17.6% in 2004 to 21.3% in 2005. Coverage was greater in states were vaccination was recommended by the U.S. Advisory Committee on Immunization Practices (ACIP). It was also found that coverage for all racial/ethnic groups increased in states where vaccination is recommended.

Problem/Condition: In the United States, acute viral hepatitis most frequently is caused by infection with hepatitis A virus (HAV), hepatitis B virus (HBV), or hepatitis C virus (HCV). These unrelated viruses are transmitted through different routes and have different epidemiologic profiles. Safe and effective vaccines have been available for hepatitis B since 1981 and, for hepatitis A, since 1995. Reporting Period: Cases in 2005, the most recent for which data are available, are compared with those from previous years. Description of the System: Cases of acute viral hepatitis are reported to CDC via the National Notifiable Diseases Surveillance System. Results: Since 1995, the incidence of reported acute hepatitis A has declined by 88%, to the lowest rate ever recorded (2005: 1.5/100,000 population). Declines were greater among children and in states where routine vaccination of children was recommended beginning in 1999, compared with the remaining states. The proportion of cases among adults has increased. Since 1990, reported acute hepatitis B incidence has declined by 79%, to the lowest rate ever recorded (2005: 1.8/100,000 population). Declines occurred among all age groups but were greatest among children aged <15 years. Since the late 1980s, acute hepatitis C incidence also has declined. In 2005, as in previous years, the majority of these cases occurred among adults, and injection-drug use was the most common risk factor. Interpretation: The greater declines in hepatitis A rates among the states and age groups included in the 1999 recommendations for routine childhood hepatitis A vaccination suggest that this strategy reduced rates. Universal hepatitis B vaccination of children has resulted in substantially lower rates among younger age groups. Higher rates of hepatitis B continue among adults, particularly males aged 25-44 years, which emphasize the need to vaccinate adults at risk for HBV infection. The decline in hepatitis C incidence is primarily attributed to a decrease in incidence among injection-drug users (IDUs). The reasons for this decrease are multifactorial and are probably related to risk-reduction practices among IDUs. Public Health Actions: The recent expansion of recommendations for routine hepatitis A vaccination to include all children in the United States aged 12-23 months is expected to further reduce hepatitis A rates. Ongoing hepatitis B vaccination programs will ultimately eliminate domestic HBV transmission, and increased vaccination of adults who have risk factors will accelerate progress toward elimination. Prevention of hepatitis C relies on identifying and counseling uninfected persons at risk for hepatitis C (e.g., IDUs) regarding ways to protect themselves from infection. [ABSTRACT FROM AUTHOR]

Presents information on Twinrix, a combined hepatitis A and B vaccine manufactured by GlaxoSmithkline Biologicals, licensed by the United States Food and Drug Administration for use in persons aged 18 years and above. Description of the vaccine; Indications and usage; Safety and immunogenicity.

Presents the recommended childhood immunization schedule for 2001 by the United States Centers for Disease Control and Prevention. Inclusion of the pneumococcal conjugate vaccine to the schedule; Recommendation of hepatitis A vaccination; Statements on vaccine information.

Looks at the use of hepatitis A vaccine in the prevention and controlling of hepatitis A issued by the Public Health Service Advisory Committee on Immunization Practices (ACIP). Persons who are at risk; Percentage of children who become infected; Vaccine programs created.

The article reports on an outbreak of hepatitis A virus (HAV) infections associated with drug use and homelessness in West Virginia in 2018. The U.S. Centers for Disease Control and Prevention (CDC) has been asked by the West Virginia Bureau of Public Health for epidemiologic assistance to respond to the outbreak. The agencies identified vaccination as the primary method for preventing an outbreak.

The article reports on the prevalence of acute Hepatitis A virus infection among previously vaccinated persons with HIV infection in Tennessee in 2018. The Tennessee Department of Health (TDH) examined the frequency at which the patients developed Hepatitis A virus infection. The Centers for Disease Control and Prevention (CDC) investigated the effect of monovalent vaccines and immune globulins (IG) on the patients.

The article reports on the increase in reported hepatitis A virus (HAV) infections among men who have sex with men (MSM) in New York City from January to August 2017. Topics include the increase in HAV infections among MSM with onsets in January to March 2017 noted by the New York City Department of Health and Mental Hygiene, description of the confirmed cases, and the importance of HAV vaccination among MSM.

GamaSTAN S/D (Grifols Therapeutics, Inc., Research Triangle Park, North Carolina) is a sterile, preservative-free solution of immune globulin (IG) for intramuscular administration and is used for prophylaxis against disease caused by infection with hepatitis A, measles, varicella, and rubella viruses (1). GamaSTAN S/D is the only IG product approved by the Food and Drug Administration for hepatitis A virus (HAV) prophylaxis. In July 2017, GamaSTAN S/D prescribing information was updated with changes to the dosing instructions for hepatitis A preexposure and postexposure prophylaxis indications. These changes were made because of concerns about decreased HAV immunoglobulin G antibody (anti-HAV IgG) potency, likely resulting from decreasing prevalence of previous HAV infection among plasma donors, leading to declining anti-HAV antibody levels in donor plasma (2). No changes in dosing instructions were made for measles, varicella, or rubella preexposure or postexposure prophylaxis. [ABSTRACT FROM AUTHOR]

The article refers to two cases of hepatitis A virus (HAV) infected patients. Topics discussed include postexposure prophylaxis (PEP) recommendations for the patients by the Health Departments of Fort Bend County and Harris County in Texas; interviews with the patients; and vaccination for HAV infected patients.

The article describes the immunization schedules recommended by the U.S. Advisory Committee on Immunization Practices (AIP) for persons aged 0 through 18 years in 2014. The schedules show recommendations for Food and Drug Administration-licensed vaccines, including several changes from the 2013 immunization schedules. They cover meningococcal conjugate, influenza and Hepatitis A vaccination.

The article presents the recommendations of the Advisory Committee on Immunization Practices (ACIP) on the use of hepatitis A vaccinations. ACIP states that international adoptees from countries with high or intermediate risks of hepatitis A entering the U.S. should receive hepatitis A vaccinations. The symptoms of the hepatitis A virus (HAV) include fever, nausea, and dark urine. Statistics of adoptees infected with HAV are also discussed.

This article reports on the approval made by the U.S. Food and Drug Administration for an application to allow use of the pediatric/adolescent formulation of Harvix for persons aged 1-18 years. The formulation of Harvix is indicated for vaccination against disease caused by hepatitis A virus. The approval included concomitant use of Harvix with Haemophilus influenzae type b conjugate vaccine.

Reports on an inactivated hepatitis A vaccine called Havrix from SmithKline Beecham Pharmaceuticals which is licensed for by the US Food and Drug Administration in adult and pediatric formulations. Results of immunogenicity studies; Administration; Interim recommendations by the Advisory Committee on Immunization Practices (ACIP) for use among international travelers.