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Hepatitis A vaccination in children under 2 remains effective for 10 years

Vaccine effective despite transfer of mothers' antibodies to hepatitis A virus to child

Vaccination against the hepatitis A virus (HAV) in children two years of age and younger remains effective for at least ten years, according to new research available in the August issue of Hepatology, a journal of the American Association for the Study of Liver Diseases (AASLD). The study found that any transfer of the mother's HAV antibodies does not lower the child's immune response to the vaccine.

The World Health Organization (WHO) estimates that 1.4 million cases of HAV occur worldwide each year. HAV affects the liver and typically occurs in areas with poor sanitation where ingestion of contaminated food or water can transmit the virus. In the U.S., HAV cases have decreased by 90% in the past 20 years, with roughly 20,000 new cases reported each year according to the Centers for Disease Control and Prevention (CDC). Experts attribute the decline in HAV cases in the U.S. to routine vaccination of children 12 to 18 months.

According to lead author Dr. Umid Sharapov, an epidemiologist with the CDC and his coauthors, this is the first study to examine the effectiveness of a two-dose inactivated hepatitis A vaccine in children younger than two years of age over a ten-year period. In addition, the researchers investigated whether maternal anti-HAV antibody transfer to their children impacts the vaccine protection against HAV.

With parental consent, researchers enrolled full-term infants who were healthy at six-months of age. Mothers were tested for total antibody to HAV. The 197 infants and toddlers were broken into three age groups: group one-infants 6 to 12 months; group two-toddlers between 12 and 18 months; and group three-toddlers 15 to 21 months of age. Each group was randomized by maternal anti-HAV status. HAV antibody levels were measured at one and six months, and additional follow-up took place at three, five, seven and ten years after the second dose of hepatitis A vaccine.

At one month following the second dose of the hepatitis A vaccine children in all groups showed signs of protection from the virus. At the ten-year follow-up most children retained anti-HAV protection. In the first group, 7% and 11% of children born to mother's without and with antibodies to the HAV virus, did not retain HAV protection from vaccination, respectively. Additionally, 4% of group three children born to anti-HAV negative mothers lost HAV protection.

"Our study demonstrates that seropositivity to hepatitis A persists for at least ten years after primary vaccination with two-dose inactivated HAV vaccine when administered to children at ages 12 months and older, regardless of their mothers' anti-HAV status," concludes Dr. Sharapov. "These findings support current CDC/ACIP guidelines for routine administration of two doses of inactivated hepatitis A vaccine to all children in the U.S. beginning at the age of 12 months." The authors point out that a future booster dose may be necessary to maintain protection against HAV and they will continue follow-up participants into their teens to monitor benefit of the initial immunization.

Full citation: "Persistence of Hepatitis A Vaccine Induced Seropositivity in Infants and Young Children by Maternal Antibody Status: 10-Year Follow-Up." Umid M. Sharapov, Lisa R. Bulkow, Susan E. Negus, Philip R. Spradling, Chriss Homan, Jan Drobeniuc, Michael Bruce, Saleem Kamili, Dale J. Hu, Brian J. McMahon. Hepatology; DOI: 10.1002/hep.25687); Print Issue Date: August, 2012. URL:

Author Contact: To arrange an interview with Dr. Sharapov, please contact the news media team at CDC's National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention at 404-639-8895 or

This study is published in Hepatology. Media wishing to receive a PDF of this article may contact .

About the Journal: Hepatology is the premier publication in the field of liver disease, publishing original, peer-reviewed articles concerning all aspects of liver structure, function and disease. Each month, the distinguished Editorial Board monitors and selects only the best articles on subjects such as immunology, chronic hepatitis, viral hepatitis, cirrhosis, genetic and metabolic liver diseases and their complications, liver cancer, and drug metabolism. Hepatology is published on is published by Wiley on behalf of the American Association for the Study of Liver Diseases (AASLD). For more information, please visit

About Wiley

Founded in 1807, John Wiley & Sons, Inc. has been a valued source of information and understanding for more than 200 years, helping people around the world meet their needs and fulfill their aspirations. Wiley and its acquired companies have published the works of more than 450 Nobel laureates in all categories: Literature, Economics, Physiology or Medicine, Physics, Chemistry, and Peace.

Our core businesses publish scientific, technical, medical, and scholarly journals, encyclopedias, books, and online products and services; professional/trade books, subscription products, training materials, and online applications and Web sites; and educational materials for undergraduate and graduate students and lifelong learners. Wiley's global headquarters are located in Hoboken, New Jersey, with operations in the U.S., Europe, Asia, Canada, and Australia. The Company's Web site can be accessed at The Company is listed on the New York Stock Exchange under the symbols JWa and JWb.

Dawn Peters | EurekAlert!
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