As the next step in the incremental immunization strategy to prevent hepatitis A, the following recommendations are made.

Children

1. All children who live in the United States should receive hepatitis A vaccine at 1 year of age (i.e., 12 to 23 months of age) as a 2-dose regimen. Immunization should be integrated into the routine childhood immunization schedule and completed according to the approved schedules (Table) using Havrix or Vaqta hepatitis A vaccines. Administration of 2 doses of the same hepatitis A vaccine is preferable. However, data indicate that the vaccines are interchangeable; thus, the 2-dose series may be completed with either of the vaccine preparations approved for children. (Connor, et. al, 2001)
2. States, counties, and communities with existing hepatitis A immunization programs for children 2 to 18 years of age are encouraged to maintain these programs and expand to include children who are 12 to 23 months of age. In these areas, new efforts focused on routine immunization of preschool children should enhance, not supplant or replace, ongoing programs that are directed at a broader population of children.
3. In areas without existing hepatitis A immunization programs, catch-up immunization of unimmunized children 2 to 18 years of age can be considered. Such programs might especially be warranted in the context of increasing incidence or ongoing outbreaks among children or adolescents.
4. Immunocompromising conditions are not a contraindication to receiving hepatitis A vaccine. The preparation is an inactivated virus and has not been shown to result in any increased safety risks when administered to people with primary or secondary immunodeficiencies.
5. The vaccine should not be administered to people with a hypersensitivity to any of the vaccine components such as aluminum hydroxide and phenoxyethanol.

Table. Recommended Doses and Schedules for Inactivated Hepatitis A Vaccines

IM indicates intramuscular.

Persons at Increased Risk of Hepatitis A Virus Infection

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