At what age is the Hepatitis A (HA) vaccine administered?

From the Guidelines

The hepatitis A vaccine is recommended for all children starting at 12 months of age, given as a two-dose series. This recommendation is based on the most recent and highest quality evidence available, which prioritizes morbidity, mortality, and quality of life as the outcome 1. The vaccine should be administered at 12-23 months of age, with the second dose given 6-18 months after the first dose to complete the vaccination series.

Key Points

• The hepatitis A vaccine is highly effective, with more than 95% of recipients developing protective antibodies after the complete series.
• The vaccine contains inactivated (killed) hepatitis A virus, which stimulates the immune system to produce antibodies without causing the disease.
• Hepatitis A vaccination is important because the virus can cause severe liver inflammation, and while most people recover completely, some may experience prolonged illness or, rarely, liver failure.
• For adults who weren't vaccinated as children, the vaccine can be given at any age, particularly for those at increased risk of hepatitis A infection or severe disease, such as international travelers, men who have sex with men, people who use drugs, individuals with chronic liver disease, and those who are homeless.

Administration Guidelines

• The vaccine can be administered to children with immunocompromising conditions, as it is an inactivated virus and has not been shown to result in any increased safety risks 1.
• However, the vaccine should not be administered to people with a hypersensitivity to any of the vaccine components, such as aluminum hydroxide and phenoxyethanol 1.
• The recommended regimens for hepatitis A vaccines are outlined in Table 2 of the CDC guidelines, which include the dose and schedule for HAVRIX and VAQTA vaccines 1.

From the Research

Hepatitis A Vaccine Administration Age

• The Hepatitis A (HA) vaccine is administered to persons 2 years or older, as stated in the study by the American Academy of Pediatrics Committee on Infectious Diseases 2.
• The major pediatric indications for the vaccine include travelers to areas with intermediate to high rates of endemic hepatitis A, children living in defined and circumscribed communities with high endemic rates or periodic outbreaks of HAV infection, and patients with chronic liver disease 2.
• A long-term strategy of sustained routine vaccination of children living in areas with consistently elevated hepatitis A rates has been adopted, with the ultimate goal of eliminating HAV transmission by vaccinating all children in the US 3.
• The availability of vaccine formulations or schedules for use in infants or children in the second year of life, and combination vaccines that include hepatitis A, would facilitate this effort 3.
• Two doses of non-live HAV vaccines are needed to ensure long-term protection, as evidenced by the systematic review of universal vaccination programs in children 4.
• Single-dose live-attenuated HAV vaccines have shown promising outcomes, but need to be monitored for many more years to document effective immune memory persistence 5, 6.