Clinical Inquiries

Who should get hepatitis A vaccination?

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A corollary question is who does not routinely need hepatitis A vaccine. In general, food service workers, sewerage workers, healthcare workers, children aged <2 years, day-care attendees, and residents of institutions for the developmentally disabled do not need routine immunization

The currently licensed inactivated hepatitis A vaccines are highly immunogenic and clinically effective in children 2 to 18 years and in adults. In a double-blind, controlled, randomized study of 1000 children in New York revealed clinical efficacy of 100%.13 A second study of 40,000 children in Thailand had a clinical efficacy of 94%.13 Numerous other studies have supported findings of near 100% immuno-genicity in all age groups and clinical efficacy in all age groups.1

CLINICAL COMMENTARY

Anyone who does not want to get hepatitis A should receive the vaccine
Richard Sams, II, MD
Camp Pendleton Naval Hospital

A good information master needs to know his resources. The question posed in this clinical inquiry is a good example. Questions about who should receive which vaccine are determined by the Advisory Committee on Immunization Practices, and their recommendations are available on the CDC’s web site (www.cdc.gov/nip/publications/acip-list.htm).

With that said, anyone who does not want to get hepatitis A should receive the vaccine. Hepatitis A is the most common vaccine preventable disease, which on occasion can be severe, especially in adults. The vaccine has no serious side effects, is highly effective and, if widely adopted, would dramatically decrease the incidence of hepatitis A in the population.

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