That's the problem in only targeting high-risk groups, he said.
Health officials should learn from the experience of hepatitis B, he said, where targeting the high-risk groups did not result in a substantial reduction in the frequency of hepatitis B. “We lost 10 years because we didn't start off with a universal vaccination program,” he said.
He gave the example of migrant children in Florida where 244 children were tested and on average half already had been infected. The numbers increased with age with 34% of the 2- to 5-year-olds testing positive for hepatitis A antibodies and 81% of the 14-year-old and over group testing positive.
“In a community that wasn't targeted, about half of the children already had been infected. This is a missed opportunity.”
The biggest impediments to universal hepatitis A vaccination in children include cost, addition of yet another vaccination to a complex schedule, and the rising fear among some parents about vaccination.