Hepatitis A Immunization Strategies: Universal versus Targeted Approaches

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Abstract
The alternative to nationwide childhood hepatitis A vaccination is to continue targeting high-risk adults. To consider how many of today’s children will become vaccination candidates, the proportion of adults reporting a lifetime history of hepatitis A risk factors was examined. One thousand thirty-four US adults responded to a confidential postal survey, 49% of whom had met current Advisory Committee on Immunization Practices (ACIP) criteria for immunization and 72% had met an expanded set of criteria. Because adult vaccination is more costly per capita, targeted vaccination may provide modest financial savings with none of the benefits associated with reduced child-to-adult transmission.