Is the Hepatitis A vaccine indicated for a 6-month-old male?

From the Guidelines

Hepatitis A vaccine is not recommended for routine administration to a 6-month-old male, but it may be considered for infants traveling to high-risk areas or with specific risk factors, as stated in the 2018 update by the Advisory Committee on Immunization Practices 1.

Key Considerations

• The standard schedule for hepatitis A vaccination begins at 12 months of age, with two doses given at least 6 months apart.
• For infants aged 6–11 months traveling internationally, simultaneous administration of MMR and HepA vaccines is recommended, but the travel-related dose should not be counted toward the routine 2-dose series 1.
• Maternal antibodies may interfere with vaccine response before 12 months, which is a consideration in the decision to vaccinate earlier than the standard schedule.
• The risk of hepatitis A infection is generally low in infants unless they are in high-risk situations, such as traveling to areas with high or intermediate HAV endemicity.

Special Circumstances

• If the 6-month-old male is traveling to a high-risk area for hepatitis A, vaccination may be considered earlier, with the understanding that the child would still need to receive the complete two-dose series beginning at 12 months.
• The vaccine approved for children is either Havrix (0.5 mL) or Vaqta (0.5 mL), administered intramuscularly, but the decision to vaccinate at an earlier age should be made on a case-by-case basis, considering the individual's risk factors and the potential benefits and limitations of early vaccination 1.

From the FDA Drug Label

HAVRIX is approved for use in persons 12 months of age and older. HAVRIX is approved for use in persons 12 months of age or older. HAVRIX is approved for use in persons 12 months of age or older.

The Hepatitis A vaccine HAVRIX is not approved for use in a 6-month-old male, as the approved age is 12 months or older 2, 2, 2.

From the Research

Hepatitis A Vaccine Administration

• The administration of hepatitis A vaccine at 6 months of age has been studied, and the results show that it is highly immunogenic and well tolerated when administered alone or concomitantly with a hexavalent vaccine 3.
• A study found that a schedule of two doses of hepatitis A vaccine, 6 months apart, beginning at 6 months of age, is highly immunogenic and well tolerated 3.
• The responses to each hexavalent vaccine antigen were similar when the hepatitis A vaccine was administered concomitantly or separately 3.

Immunogenicity and Tolerability

• Hepatitis A vaccine has been shown to be immunogenic following administration of a delayed immunization schedule in infants, children, and adults 4.
• A booster dose administered 20-31 months after the primary dose was found to be immunogenic, with strong responses in children over 2 years old and adults 4.
• The vaccine was generally well tolerated in both groups, regardless of the vaccine(s) administered 3.

Recommendations and Guidelines

• The American Academy of Pediatrics Committee on Infectious Diseases has developed guidelines for the use of hepatitis A vaccine and immune globulin, recommending vaccination for 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 5.
• The committee also recommends immune globulin for postexposure prophylaxis, as vaccine has not yet been demonstrated to be protective for this purpose 5.
• A long-term strategy of sustained routine vaccination of children living in areas with consistently elevated hepatitis A rates has been adopted, with the goal of ultimately eliminating HAV transmission 6.