ATLANTA — Hepatitis A vaccination should be given to all previously unvaccinated nontraveling individuals who will be in close personal contact with an internationally adopted child, the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention voted at its winter meeting.
When adoption is planned for a child from a country of high or intermediate hepatitis endemicity, persons who will have close personal contact with the adoptee during the first 60 days following arrival of the adoptee in the United States should be identified. The first dose of hepatitis A vaccine should be administered as soon as the adoption is planned, and ideally the first two doses given at least 2 weeks prior to the arrival of the adoptee, according to ACIP.
Previously, ACIP recommended vaccination only of adoptive parents and others who actually travel to the country with high or intermediate hepatitis A endemicity, said Dr. Sandra Chaves of the CDC's division of viral hepatitis.
In June 2007, a 51-year-old grandmother of 12-month-old adopted twins developed fatal fulminant hepatitis A. The twins had hepatitis A but were not jaundiced. That case prompted the discovery of 20 more cases of hepatitis A among nontraveling contacts of international adoptees during 2006–2007. Nearly all of the countries from which Americans adopt children are endemic for hepatitis A, Dr. Chaves noted.
The risk of hepatitis A infection is about 106 per 100,000 close contacts of international adoptees in the United States, and about 1.2/100,000 in the general population, Dr. Chaves said.