ACIP Updates Hepatitis A Vaccine Recommendations

Currently, the US Centers for Disease Control and Prevention (CDC) recommends the hepatitis A vaccine for children 12 to 23 months and catch-up vaccinations for any individuals over 2 years of age.

However, the CDC’s Advisory Committee on Immunization Practices (ACIP) has voted to update recommendations on the use of vaccines to protect against hepatitis A.

The committee voted unanimously to recommend that all children and adolescents between the ages of 2 and 18 years who have not previously received the hepatitis A vaccine should receive a catch-up vaccination. ACIP also voted unanimously to recommend updating the language around using the hepatitis A vaccine in the Vaccines for Children program.

Both recommendations are currently under review by Robert Redfield, MD, director of the CDC, along with the Department of Health and Human Services. Details on the recommendations from ACIP and the final recommendations of the CDC will be published upon finalization in the CDC’s Morbidity and Mortality Weekly Report.

Currently available hepatitis A vaccines for pediatric and adult populations include Havrix (GlaxoSmithKline) and Vaqta (Merck.) Patients over the age of 18 years can also receive (GlaxoSmithKline), which is a combined hepatitis A and B vaccine.

Vaqta and Havrix are both indicated for the prevention of hepatitis A in individuals 12 months of age and older. The primary dose should be given at least 2 weeks prior to exposure to the hepatitis A virus. A booster dose should be administered intramuscularly 6 to 18 months later.

“Today’s ACIP vote comes at a time when the United States continues to experience a widespread outbreak of hepatitis A with more than 20,000 cases reported since 2017,” said Richard M. Haupt, MD, MPH, vice president and head of vaccines and infectious diseases, Global Medical Affairs at Merck, who produces the Vaqta vaccine, in a statement. “We strongly support ACIP’s votes on hepatitis A vaccination recommendations, including the vote to strengthen the recommendation that children and adolescents aged 2 through 18 years who have not previously received vaccination be routinely vaccinated at any age. We look forward to the CDC’s final, published recommendations.”

As of June 28, 2019, there have been over 21,230 cases of hepatitis A reported across 25 states since the outbreaks were first identified in 2016. Of these cases, there have been 12,476 hospitalizations, which is an overall hospitalization rate of 59%, and 203 deaths.

According to the CDC, just 1 dose of a single-antigen vaccine has been shown to control outbreaks of hepatitis A and provide up to 95% seroprotection in healthy individuals for up to 11 years.

In a previous interview with Contagion®, Donald Jensen, MD, FACP, FAASLD, a professor of medicine at Rush University Medical Center in Chicago, Illinois, explained that administering the hepatitis A vaccine in children is important to provide future protection.

“Since 2006, the ACIP has recommended that all children in the USA receive the hepatitis A vaccine. Making it mandatory certainly raises the likelihood of broad immunity. That said, children rarely have serious outcomes with HAV, so the vaccination of children is largely to produce a generation of later-protected adults,” Jensen said.

For state-by-state case counts in the ongoing hepatitis A outbreaks, check out the Contagion® Outbreak Monitor.