TABLE 1. Recommendations for postexposure prophylaxis and preexposure protection, by age group and risk category.
| Indication/Age group | Risk category/Health status | Hepatitis A vaccine | Immune globulin |
|---|---|---|---|
|
Postexposure prophylaxis
| |||
| <12 mos |
Healthy |
No |
0.1 mL/kg* |
| 12 mos–40 yrs |
Healthy |
1 dose† |
None |
| >40 yrs |
Healthy |
1 dose† |
0.1 mL/kg§ |
| ≥12 mos |
Immunocompromised or chronic liver disease |
1 dose† |
0.1 mL/kg¶ |
| ≥12 mos |
Vaccine contraindicated** |
No |
0.1 mL/kg |
|
Preexposure protection††
| |||
| <6 mos |
Healthy |
No |
0.1–0.2 mL/kg§§ |
| 6–11 mos |
Healthy |
1 dose¶¶ |
None |
| 12 mos–40 yrs |
Healthy |
1 dose*** |
None |
| >40 yrs |
Healthy |
1 dose*** |
0.1–0.2 mL/kg§§,††† |
| All ages |
Immunocompromised or chronic liver disease |
1 dose*** |
0.1–0.2 mL/kg§§,††† |
| >6 mos | Persons who elect not to receive vaccine or for whom vaccine is contraindicated** | No | 0.1–0.2 mL/kg§§ |
* Measles, mumps, and rubella vaccine should not be administered for at least 3 months after receipt of IG.
† A second dose is not required for postexposure prophylaxis; however, for long-term immunity, the hepatitis A vaccination series should be completed with a second dose at least 6 months after the first dose.
§ The provider’s risk assessment should determine the need for immune globulin administration. If the provider’s risk assessment determines that both vaccine and immune globulin are warranted, HepA vaccine and immune globulin should be administered simultaneously at different anatomic sites
¶ Vaccine and immune globulin should be administered simultaneously at different anatomic sites.
** Life-threatening allergic reaction to a previous dose of hepatitis A vaccine, or allergy to any vaccine component.
†† IG should be considered before travel for persons with special risk factors for either HAV infection or increased risk for complications in the event of exposure to HAV.
§§ 0.1 mL/kg for travel up to 1 month; 0.2 mL/kg for travel up to 2 months, 0.2mL/kg every 2 months for travel of ≥2 months’ duration.
¶¶ This dose should not be counted toward the routine 2-dose series, which should be initiated at age 12 months.
*** For persons not previously vaccinated with HepA vaccine, administer dose as soon as travel is considered, and complete series according to routine schedule.
††† May be administered, based on providers’ risk assessment.