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Risk factors for hepatitis A (hep A) acquisition include illicit drug use (injection and noninjection), homelessness, and being among the population of men who have sex with men (MSM). Between 1995 and 2011 (coincident with recommendations to vaccinate members of high-risk groups), overall incidence of hep A fell by 95%, then plateaued until 2015. Incidence then rose by 294% during 2016–2018, mostly in persons in these high-risk groups. Despite recommendations, hep A vaccination levels remain low in MSM.
From 2017 through 2018, data from 8 states reporting to the CDC totaled 260 confirmed cases in MSM compared with 16 cases in MSM from all 50 states recorded during the previous 2 years. The highest case numbers were in New York and Californi…