Low vaccination rate puts teens at risk for hepatitis A

Less than half of adolescents have been vaccinated against the hepatitis A virus, according to analysis by researchers at the Centers for Disease Control and Prevention (CDC).

Adolescents are more likely to receive vaccination for hepatitis A when a health care provider recommends it, but unfortunately only one-fourth of teens in the CDC’s analysis received such a recommendation.

“Provider concerns about vaccine reimbursement and insurance coverage and some physicians’ perception that hepatitis A is not a significant health problem have been identified as barriers to recommending HepA [vaccine],” the researchers note.

Investigators analyzed data on hepatitis A coverage among 13- to 17-year-olds who participated in the 2009 National Immunization Survey-Teen. They found that 42% of adolescents in this age group received at least 1 dose of the HepA vaccine and 29.5% received 2 doses.

In the 11 states in which the Advisory Committee on Immunization Practices (ACIP) has recommended hepatitis A vaccination since 1999, 74.3% received at least 1 dose of the vaccine. In the 6 states in which vaccination was recommended to be considered (since 1999), the coverage rate was 54%. In the remaining states in which vaccination has been recommended only since 2006, the uptake (at least 1 dose) was 27.8%. Since 2006, ACIP has recommended routine hepatitis A vaccination for all US children beginning at 1 year.

Poverty rates were not tied to vaccine initiation, except in states in which the HepA vaccine has been recommended only since 2006, which researchers attribute to the federal Vaccines for Children program.

Coverage rates increased by 30% to 160%, depending on state vaccination recommendations, when vaccination was suggested by a health care provider, yet only 25% of the sample reported receiving a provider recommendation for HepA vaccine.

The researchers suggest that health care providers can significantly increase vaccination rates by educating themselves and parents about both the severity of hepatitis A infection among adolescents and the safety and efficacy of the HepA vaccine in preventing the disease.

Go back to the current issue of the eConsult.