Most US Teenagers Lack Hepatitis A Immunization

From Medscape Medical News Daniel M. Keller, PhD January 23, 2012 — Most adolescents in the United States lacked immunization for hepatitis A in 2009, leaving them susceptible to hepatitis A infection going into adulthood. In the first study to evaluate hepatitis A vaccine (HepA) coverage in the United States, using data from healthcare providers, researchers from the US Centers for Disease Control and Prevention in Atlanta, Georgia, reported in an article published online January 23 and in the February print issue of Pediatrics that nationally, 1-dose coverage with HepA among adolescents was 42.0%. Of those teenagers who were vaccinated, approximately 70% completed the 2-dose series, which is equivalent to 29.5% of the entire cohort of adolescents surveyed. Using data from the 2009 National Immunization Survey-Teen (N = 20,066) to determine HepA coverage among 13- to 17-year-olds, Christina Dorell, MD, MPH, and coauthors found that among states in which the Advisory Committee on Immunization Practices (ACIP) has recommended universal child vaccination at 2 years since 1999 (group 1), 1-dose coverage was 74.3%. Among states with an ACIP recommendation for consideration for child vaccination at 2 years since 1999 (group 2), the rate was 54.0%, and among states with a recommendation of universal child vaccination at 1 year of age since 2006 (group 3), the rate was 27.8%. The researchers noted that 1 dose of vaccine induces protective levels of antibodies in more than 97% of infants and children, and a second dose is thought to confer long-lasting immunity. Because hepatitis A virus is highly infectious and will probably continue to be introduced to the United States through imported food, international travel, international adoption, and other means, the authors recommend continued vaccination of adolescents to protect them during this period, and as they mature into adults. In this way, the prevalence of significant hepatitis A disease may be minimized, lowering morbidity, hospitalizations, lost work, and the large expense of containment efforts. The authors have disclosed no relevant financial relationships. Pediatrics. 2012;129:213-221. Abstract