CDC Updates Guidelines on Pre- and Postexposure Protection Against Hepatitis A

By Kelly Young

Edited by André Sofair, MD, MPH, and William E. Chavey, MD, MS

The CDC has published its latest guidance on pre- and postexposure prophylaxis with hepatitis A vaccine or immune globulin in MMWR.

For postexposure protection, the CDC now recommends that patients aged 1 year and older receive the hepatitis A vaccine. Those aged 40 and up may also receive immune globulin, based on the clinician's risk assessment. (The agency previously recommended the vaccine for people aged 1 to 40 years and immune globulin for other age groups).

For preexposure protection during international travel to hepatitis A-endemic regions, the CDC recommends that infants aged 6–11 months be vaccinated. The vaccine may be administered simultaneously with the measles-mumps-rubella vaccine. The hepatitis A vaccine dose shouldn't count toward the child's routine two-dose series that begins at 12 months. Travel recommendations for other age groups are largely unchanged.

In the same issue of MMWR, researchers report that in 2017, California, Kentucky, Michigan, and Utah had over 1500 cases of hepatitis A, largely among those who used drugs or were homeless. The authors conclude: "Increasing vaccination among groups at risk for hepatitis A infection might halt ongoing outbreaks and prevent future outbreaks."