Immunization rates for hepatitis A in children aged 24–35 months vary widely across areas and populations in the United States, the Centers for Disease Control and Prevention said.
In 1999, the CDC recommended routine immunization against hepatitis A for children residing in 11 states in which the average annual incidence during 1987–1997 was at least 20 per 100,000 population, or twice the national average. Those states are Alaska, Arizona, California, Idaho, Nevada, New Mexico, Oklahoma, Oregon, South Dakota, Utah, and Washington. They also advised that hepatitis A vaccination be considered in another six states (Arkansas, Colorado, Missouri, Montana, Texas, and Wyoming) where the average incidence was 10–20/100,000 population (MMWR 2005;54:141–5).
Data were collected from provider immunization records for 13,731 children during 2003. In the 11 states in which routine vaccination is recommended, the proportion of children aged 24–35 months who had received at least one dose of vaccine varied from a low of 6.4% (South Dakota) to a high of 72.7% (Alaska).
In the six states where hepatitis A vaccination should be considered, 25.0% of children aged 24–35 months had been vaccinated, compared with just 1.4% in the other 33 states with no recommendation. The wide variation in coverage is likely due to targeted programs. For example, vaccination requirements in Texas border counties for all children attending day care programs probably account for the higher coverage in El Paso County (71%), compared with the rest of the state, the CDC said.