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What measures can we take to prevent hepatitis A infections?

There are several steps that can be taken to help reduce the burden of hepatitis A:

Hand washing Icon

Reducing the spread of hepatitis A1,2

Vaccination Icon

Vaccination1,2

Herd immunity Icon

Introduce universal vaccination programmes that will help to achieve herd immunity and reduce the burden of disease1–6

Hand washing icon

Reducing the spread of hepatitis A by:1,2

  • Improving food safety
  • Having adequate supplies of safe drinking water
  • Proper disposal of sewage within communities 
  • Personal hygiene practices such as regular hand washing before meals and after going to the bathroom
Vaccination Icon

Vaccination

For intermediate or shifting endemicity countries, WHO recommends vaccination against Hep A for:

Children7

  • All children aged ≥12 months on the basis of an increasing trend over time of acute hepatitis A disease and considerations of cost-effectiveness

There is no specific treatment for hepatitis A. WHO recommends vaccination, in addition to improved sanitation and food safety, as one of the most effective ways of combatting hepatitis A1

 

For low and very low endemicity countries, WHO recommends vaccination against Hep A for:

High risk groups7

Although anyone who has not been vaccinated or previously exposed to HAV can get infected with HAV, certain groups of people are at higher risk for getting infected and for having severe disease if they do get hepatitis A, these include:2,7

  • International travellers
  • People who use injection or non-injection drugs
  • People with occupational risk of exposure
  • People who anticipate close personal contact with an infected person
  • People experiencing homelessness
  • People with chronic liver disease, including people living with hepatitis B and/or hepatitis C
  • People with HIV infection
  • Men who have sex with men 
  • Migrants and refugees
  • Incarcerated persons

WHO recommends targeted vaccination of high-risk groups against hepatitis A7

In highly endemic countries for HAV, most individuals are asymptomatically infected with HAV in childhood, which prevents clinical hepatitis A in adolescence and adulthood.7 Therefore, WHO does not routinely recommend UV programmes, as they could increase the incidence of HAV in unvaccinated people7

Universal Vaccination Icon

Introduction of a universal vaccination (UV) programme helps achieve herd immunity and reduce the burden of disease1–6

Implementation of UV programmes for hepatitis A has been successful in decreasing the overall incidence of hepatitis A in a number of regions, e.g. Uruguay, Israel, Panama and Argentina3,4,6

How important is vaccination for the prevention of hepatitis A?

Routine childhood vaccination may help:5

  • Prevent infection in age groups that account for at least one third of the cases
  • Eliminate a major source of infection for other children and for some adults
  • Eventually prevent infection in older people as vaccinated children become adults, because immunity appears to be long-lasting 

Long-term protection has been demonstrated with two doses of Havrix Junior8,9

Vaccination programmes are effective and decrease hepatitis A infection rates4,6,10–12

The following figure represents trends over time for the incidence of viral hepatitis A-related outcomes for children, adolescents and adults in Panama.4 A decreasing trend is observed towards the early 2000's due to major sanitary improvements; however, the introduction of UV programmes induced a greater decline in hepatitis A incidence4

Vaccination program Graph

The same results were first published in Estripeaut et al. 20154
The graph has been independently created by GSK from the original data

Find out more about hepatitis A and Havrix Junior

Long-term protection

Discover the benefits of Havrix Junior

A summary of hepatitis A vaccines

A quick reference guide to hepatitis A vaccines

Universal vaccination

Review the evidence for UV

HAV, hepatitis A virus; HIV, human immunodeficiency virus; UV, universal vaccination; WHO, World Health Organization

References

  1. World Health Organization (WHO). Hepatitis A fact sheet. Available at: https://www.who.int/news-room/fact-sheets/detail/hepatitis-a (Accessed April 2023).
  2. Centers for Disease Control and Prevention (CDC). Hepatitis A questions and answers for the public. Available at: https://www.cdc.gov/hepatitis/hav/afaq.htm#prevent (Accessed April 2023).
  3. Chodick G et al. J Viral Hepatitis 2008; 15:62–65.
  4. Estripeaut D et al. Vaccine 2015; 33:3200–3207.
  5. Centers for Disease Control and Prevention. MMWR Recomm Rep 1999; 48:1–37.
  6. Stuurman AL et al. Hum Vaccin Immunother 2017; 13:724–736.
  7. World Health Organization. Wkly Epidemiol Rec 2022; 97:493–512.
  8. Havrix Junior SmPC, January 2022.
  9. Agrawal A et al. Infect Dis Ther 2020; 9:785–796.
  10. Dagan R et al. JAMA 2005; 294:202–210.
  11. Vizzotti C et al. J Pediatr Infect Dis Soc 2015; 4:e62–e67.
  12. Urueña A et al. Pediatr Infect Dis J 2016; 35:1339–1342.

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PM-RCH-HAV-WCNT-230002 | Date of preparation: Noember 2023