Should all children be immunised against hepatitis A?
BMJ 2006;332:715-718
Jonathan L Temte, associate professor1
University of Wisconsin, Department of Family Medicine, Madison, WI 53715, USA Jon.Temte@fammed.wisc.edu

Hepatitis A might be the next vaccine to be introduced into the routine schedule in the USA. That will mean 28 immunisations for kids.

It is a very effective vaccine, but interestingly routine vaccination now only has a marginal cost-benefit ratio because previous campaigns of taregeted Immunisation have reduced the prevalence of Hep A infection. MIKE

Summary points

Vaccination of all children aged 12-23 months for hepatitis A virus has been recommended in the United States

This raises the total number of recommended immunisations for children and adolescents from 26 to 28

The estimated cost for full childhood and adolescent immunisation is $1118 per child, but will probably be cost saving

Recommendations for vaccinations are based on the prevalence and severity of disease caused by infection but because targeted vaccination has reduced the prevalence of hepatitis A this vaccine is now only just above the cut-off margin