State of California—Health and Human Services Agency
Department of Health Services

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ARNOLD SCHWARZENEGGER
Governor

SANDRA SHEWRY
Director

IZB-FY-0506-12B

January 30, 2006

TO: Health Officers
Immunization Coordinators
FROM: Howard Backer, M.D., M.P.H., Chief
Immunization Branch
SUBJECT: New Hepatitis A Recommendations

The hepatitis A vaccine licensure was recently expanded by the Food and Drug Administration
from age two to age one year. This expansion affects both vaccines licensed in the United
States, Merck’s product, VAQTA® and Glaxo Smith Kline’s product, Havrix®.

In October 2005, Advisory Committee on Immunization Practices (ACIP) also approved
expanded recommendations for Hepatitis A Vaccination of Children
(http://www.cdc.gov/vaccines/recs/provisional/recs/hepA_child.pdf). In accordance with ACIP,
Department of Health Services, Immunization Branch also recommends that all children should
receive hepatitis A vaccine beginning at one year of age (i.e., 12-23 months). Vaccination
should be completed according to the licensed schedules and integrated into the routine
childhood and adolescent vaccination schedule. Children who are not vaccinated by two years
of age can be vaccinated at subsequent visits. New efforts focused on routine vaccination of
one year old children should enhance, not replace, ongoing programs directed at a broader
population of children.

Prior recommendations for statewide childhood immunization with hepatitis A vaccine were
limited to California and other states with a higher incidence of hepatitis A disease. Childhood
immunization has been very successful in reducing hepatitis A disease in all ages in these
states, including California. (See Wasley A, Samandari T, Bell BP. Incidence of hepatitis A in
the United States in the era of vaccination. JAMA. 2005 Jul 13; 294:194-201.) Therefore, ACIP
is now recommending nationwide childhood immunization with hepatitis A vaccine. In the
future, more children moving into California from other states will have been previously
immunized with hepatitis A vacccine than in the past, reducing the need for immunization by
their new provider in California.

Reporting Hepatitis A Usage

The Monthly Vaccine Usage Report (DHS 8297 1/06) has been revised to include the new age
range for hepatitis A vaccine. A copy of the revised Monthly Vaccine Usage Report is enclosed.
Immunization Branch

850 Marina Bay Parkway, Building P, Richmond, CA 94804
(877) 243-8832
Internet Address: www.dhs.ca.gov