What to Do If Your Child Is Exposed to Hepatitis A

Hepatitis A is a vaccine preventable disease.

The hepatitis A vaccine was first added to the immunization schedule in 1996, but wasn’t made a universal recommendation for all children until 2006. At first, it was just given to high risk kids.

Now all toddlers begin to get a two dose hepatitis A vaccine series beginning when they are 1 to 2 years old, with 6 to 18 months between the doses.

Unfortunately, unlike many other vaccines, there was never a catch-up plan for those who were unvaccinated, so some teens and many adults are still not vaccinated and still not protected against hepatitis A infections.

Getting Exposed to Hepatitis A

How do you get hepatitis A?

“The hepatitis A virus is able to survive outside the body for months. High temperatures, such as boiling or cooking food or liquids for at least 1 minute at 185°F (85°C), kill the virus, although freezing temperatures do not.”

CDC on Hepatitis A Questions and Answers

Unlike hepatitis B, which is spread through blood and body fluids, people who are infected with hepatitis A shed the virus in their stool.

So you can get infected by having close contact with someone who has hepatitis A or by eating or drinking contaminated food or water.

How do you know if you have been exposed?

Exposures are most common in local common-source outbreaks caused by sick food handlers at restaurants and grocery stores and multi-state hepatitis A outbreaks caused by contaminated foods. These types of exposures are usually announced by your local or state health department.

Other exposures occur if you are living with someone who develops hepatitis A or travel to a country where hepatitis A is still common.

What to Do If Your Unvaccinated Child Is Exposed to Hepatitis A

If your unvaccinated child is exposed to hepatitis A, you should talk to your pediatrician or local health department about starting post-exposure prophylaxis as soon as possible and not longer than 14 days, including either:

• the first dose of hepatitis A vaccine, with plans to get the second dose of vaccine in 6 months, or
• a dose of immune globulin (provides a passive transfer of antibodies)

In general, getting the hepatitis A vaccine is preferred over getting immune globulin for most healthy people between 12 months and 40 years of age. For infants less than 12 months (too young to be vaccinated) and unvaccinated adults over age 40 years, immune globulin is preferred after an exposure to hepatitis A.

Immune globulin is also preferred for anyone who is immunocompromised or chronic liver disease.

What if it has been more than 14 days since the exposure?

While it is likely too late for immune globulin, your unvaccinated child should still likely get a dose of hepatitis A vaccine to protect against future exposures. And watch carefully over the next 15 to 50 days (the incubation period) for symptoms of hepatitis A, which can include jaundice, fever, and vomiting, etc. Many children don’t have symptoms though, so your child could develop hepatitis A, and be contagious and expose others without your even knowing it.

If post-exposure vaccination works, can’t you just wait until your child is exposed to get vaccinated? That might work – if you could be sure about each and every exposure that your child will ever have. Since that’s not possible, don’t delay getting vaccinated and put your child at risk of getting hepatitis A.

What to Do If Your Vaccinated Child Is Exposed to Hepatitis A

The hepatitis A vaccine is very effective.

One dose provide 95% protection against hepatitis A infections and the second dose boosts the efficacy rate up to 99%.

If your child is partially vaccinated, with just one dose and has been exposed to hepatitis A, get the second dose if it has been at least six months since he was vaccinated. Otherwise, talk to your pediatrician or local health department, but your child is likely considered protected.

Preexposure Protection Against HAV Infection for Travelers

In addition to getting the hepatitis A vaccine as preexposure prophylaxis, it is now recommended that a dose be given to infants aged 6–11 months who will be traveling outside the United States when protection against hepatitis A is recommended.

This early dose doesn’t count towards the two dose routine schedule, but can provide early protection until they are old enough to get their routine vaccine later.

Infants younger than 6 months can get immune globulin as needed for postexposure prophylaxis and preexposure protection.

What to Know About Getting Exposed to Hepatitis A

Learn what to do if your child is exposed to hepatitis A, especially if they aren’t already vaccinated and protected.

More on Getting Exposed to Hepatitis A

• What to Do if Your Child Is Exposed to Chicken Pox?
• What to Do If Your Child Is Exposed to Measles
• What to Do If Your Child Is Exposed to Meningitis
• What to Do If Your Child Is Exposed to the Flu
• What to Do If Your Child Is Exposed to Pertussis
• What to Do If Your Child Is Exposed to Hepatitis B
• What to Do If Your Child Is Exposed to Rabies
• What to Do If Your Child Is Exposed to Mumps
• CDC – Prevent Hepatitis A: Get Vaccinated Before You Travel
• Ask the Experts about Hepatitis A Vaccines 
• CDC – Hepatitis A Vaccine Questions and Answers
• CDC – Hepatitis A Questions and Answers
• MMWR – Update: Recommendations of the Advisory Committee on Immunization Practices for Use of Hepatitis A Vaccine for Postexposure Prophylaxis and for Preexposure Prophylaxis for International Travel
• CDC – Hepatitis A ACIP Vaccine Recommendations
• CDC – Postexposure Prophylaxis for Hepatitis A
• CDC – Update: Prevention of Hepatitis A After Exposure to Hepatitis A Virus and in International Travelers. Updated Recommendations of the Advisory Committee on Immunization Practices (ACIP)
• CDC – Updated Dosing Instructions for Immune Globulin (Human) GamaSTAN S/D for Hepatitis A Virus Prophylaxis
• Hepatitis A Prevention Mandates for Daycare and K-12
• WHO – Hepatitis A Fact Sheet
• CDC WONDER On-line Database. Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File 1979-1998 and 1999-2015.
• Study – Incidence of Hepatitis A in the United States in the Era of Vaccination
• Louisville Kroger store employee diagnosed with hepatitis A

Last Updated on April 6, 2024