Given the various health challenges that parents and health care practitioners are dealing with today, hepatitis A may not be the first infectious disease that comes to mind for parents grappling with how to best protect their children. What many people don’t know is that there is a widespread outbreak of hepatitis A that has been sweeping the U.S. since 2016.
This rise in hepatitis A cases has predominantly resulted from person-to-person contact, with infection occurring mostly among adults using drugs or experiencing homelessness. However, children under 18 years of age are also at risk for hepatitis A and require vaccination, a fact many parents may not understand. And what’s more, preventative measures among certain risk groups can have a significant impact on protecting the health of the overall community. Health care practitioners themselves are critical to discussing — and encouraging, when appropriate — hepatitis A vaccinations with families.
What the CDC Says
The U.S. Centers for Disease Control and Prevention (CDC) supports routine hepatitis A vaccination in children 1-18 years of age. While the CDC has recommended all one-year-olds (ie, 12-23 months) in the U.S. routinely receive the hepatitis A vaccine since 2006, the CDC went even further in July 2020. As an update on their official guidance, the CDC now recommends that all children and adolescents aged 2-18 years should be vaccinated against hepatitis A if they haven’t been already, known as “catch-up vaccination.”
Why the change after nearly fifteen years? By increasing vaccination rates for this at-risk age group, we can build a herd immunity that can help reduce the spread of infection among the larger population and, in particular, vulnerable adults. Currently only ~62% of children receive two or more doses of hepatitis A vaccine by the age of 19-35 months, well below the Healthy People 2020 goal of 85%. This does however increase to ~68% when looking at adolescents aged 13-17 years, as the 2006 universal cohort has reached adolescence.
Making the Case for Hepatitis A Vaccination to Parents
In order to achieve this vision, the CDC guidelines need to be put swiftly into action. This will first require a review of existing practice protocols and processes to ensure patients aged 2-18 years are routinely assessed for hepatitis A vaccination and then followed up on to receive a complete series.
This pre-identification will help prepare for these important conversations with parents as routine pediatric visits offer vital opportunities to get children aged 2-18 years fully vaccinated and convey valuable information. Pediatricians can help explain to parents what the new CDC recommendations mean for their child and discuss why vaccination is important.
When speaking to parents who may not be familiar with children’s risk for hepatitis A, start with a question that is likely top of mind: how their child could contract the virus. Hepatitis A may often be associated with contaminated food or water, but kids are actually much more likely to be infected through human contact or contaminated surfaces. Taking precautions to help protect children from hepatitis A is just as important as protecting them from any other vaccine-preventable diseases.
The Bottom Line
We should not overlook hepatitis A as a highly-contagious infection with rapidly-increasing incidence in the U.S., including among children under 6 years of age who can appear asymptomatic and be transmitters of the virus. It’s important to remain vigilant in vaccination and protection against all preventable diseases that continue to affect us.
Now more than ever, it is critical that we proactively address hepatitis A with parents, improve education about CDC guidelines for protection against all infectious diseases and share resources for people to learn more about how they can protect themselves. For more information, visit https://www.vaccines.gov/diseases/hepatitis_a.
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