Is Hepatitis A Included in the Standard Childhood Vaccine Schedule?
Yes, hepatitis A vaccine is now part of the standard childhood immunization schedule in the United States, with all children recommended to receive the first dose at 12-23 months of age. 1, 2
Evolution of Hepatitis A Vaccination Recommendations
The hepatitis A vaccine recommendation has evolved significantly over the past two decades:
Prior to 2006: Hepatitis A vaccine was only recommended for routine use in selected states and regions with high disease rates, and for certain high-risk groups. 1 The vaccine was initially licensed for children ≥24 months in 1995, and recommendations were limited to communities with the highest disease rates. 3
2005-2006 Transition: The FDA lowered the minimum licensed age to 12 months in August 2005, and in May 2006, the Advisory Committee on Immunization Practices (ACIP) recommended routine vaccination of all children aged 12-23 months, regardless of risk category or geographic location. 1, 3
Current Standard: As of 2007 and continuing through current guidelines, hepatitis A vaccination is integrated into the routine childhood immunization schedule for all U.S. children. 1, 2
Standard Vaccination Schedule
All children should receive a 2-dose hepatitis A vaccine series beginning at 12-23 months of age: 1, 2
- First dose: Administered at 12-23 months of age 1, 2
- Second dose: Given 6-12 months later for Havrix or 6-18 months later for Vaqta 1, 2
- Interchangeability: The two doses may be completed with either vaccine preparation, as they are interchangeable 1, 2
Impact of Universal Vaccination
The expansion to universal childhood vaccination has been highly successful:
- Hepatitis A incidence reached historic lows following the 2006 recommendation, with a 76% reduction compared to pre-vaccine era rates. 1
- Age, ethnic, racial, and regional differences in hepatitis A incidence have been virtually eliminated. 1
- Strong herd immunity effects have been observed, with significant disease reduction in unvaccinated adults. 1
Catch-Up Vaccination
Children and adolescents who were not previously vaccinated can begin the hepatitis A series during any visit: 1
- States with existing programs for children 2-18 years should maintain these programs while expanding to include younger children. 1
- In areas without existing programs, catch-up vaccination of unimmunized children 2-18 years of age can be considered, particularly during outbreaks. 1
Important Clinical Considerations
- No contraindication for immunocompromised children: The vaccine is inactivated and safe for children with primary or secondary immunodeficiencies. 1
- Interrupted schedules: If the vaccination schedule is interrupted, only the required doses need to be administered—there is no need to restart the series. 1, 2
- Storage requirements: Store between 2-8°C (36-46°F); do not freeze, as freezing destroys vaccine potency. 1, 2