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Vaccine Preventable Disease Control
County of Los Angeles
Department of Public Health
Vaccine Preventable Disease Control Program
3530 Wilshire Blvd. Suite 700
Los Angeles, CA 90010
Phone: (213) 351-7800
Email: ip@ph.lacounty.gov
May 5, 2025: Public Health Declares Hepatitis A Outbreak in Los Angeles County.
Click here to read the press release.
The hepatitis A vaccine protects infants, children, and adults from hepatitis A. These vaccines are routinely provided during the primary infant vaccination series. The vaccine is recommended for adolescents and adults at high risk of infection or severe disease as described below, as well as anyone seeking protection.
Who SHOULD get the vaccine:
The Advisory Committee on Immunization Practices (ACIP) recommends hepatitis A vaccination for the following:
Children
People at increased risk for getting infected
People at increased risk for severe disease from HAV infection
Other persons recommended for vaccination
Vaccination during outbreaks
Vaccination in settings providing services to adults
Who should NOT get the vaccine (if applicable):
Hepatitis A vaccine is widely available at primary care provider offices, pharmacies, and participating community sites serving uninsured people. It is also available at no cost at LAC DPH clinics. For clinic hours and locations, refer to the Nurse Clinic information (available in English and Spanish).
Most private health insurance plans should cover hepatitis A vaccine at no cost to beneficiaries.
Medi-Cal: Hepatitis A vaccine is covered for patients enrolled in both fee-for-service and managed care plans. Administration is covered when provided at the patient’s established provider’s office or by an in-network pharmacy. No prior authorization is required. Patients—or those assisting them—can call the plan’s member services number listed on the back of their Medi-Cal Benefits Identification Card for pharmacy service information. Prior to referring a patient to an in-network pharmacy, please confirm vaccine availability directly with the pharmacy.
AIDS Drug Assistance Program (ADAP): Hepatitis vaccine is included on the ADAP formulary.
If you are uninsured or underinsured, there are programs available to help cover the cost of vaccines. Children who are 18 years of age or younger are eligible to receive vaccines at no cost through the Vaccines for Children (VFC) Program if they are:
Uninsured or underinsured adults can access free or low cost vaccines at select clinics enrolled in the Vaccines for Adults (VFA) program. For more information on who is eligible, read VFA Eligibility Based on Insurance Status. You can use the following resources for more information on locating clinics:
You can also dial 2-1-1 for a list of free or low cost vaccine clinics. This includes Vaccines for Children (VFC) provider locations that serve Medi-Cal eligible children and uninsured or underinsured adults. Learn more about specific vaccine information for different age groups:
Are you not sure if you have been vaccinated against hepatitis A or you can’t find your vaccine records?
If you need official copies of your vaccine records, or if you need to update your personal records:
Table 1: Hepatitis A Vaccines
| Trade Name (manufacturer) |
Age group (yrs) | Dosage | Route | Number of Doses & Schedule |
Booster |
|---|---|---|---|---|---|
| Havrix (GlaxoSmithKline) |
1-18 | 0.5 mL | IM | 2 doses at 0, 6-12 months | None |
| ≥19 | 1 mL | IM | 2 doses at 0, 6-12 months | None | |
| Vaqta (Merck) |
1-18 | 0.5 mL | IM | 2 doses at 0, 6-18 months | None |
| ≥19 | 1 mL | IM | 2 doses at 0, 6-18 months | None | |
| Twinrix* (GlaxoSmithKline) |
≥18 (primary) | 1 mL | IM | 3 doses at 0, 1, 6 months | None |
| ≥18 (accelerated schedule) | 1 mL | IM | 3 doses at 0, 7, 21-30 days | 12 months |
*Twinrix is not recommended for post – exposure prophylaxis.
Pre-exposure prophylaxis — The primary tool for protection against hepatitis A prior to exposure is vaccination, which is superior to immune globulin with respect to achievable antibody concentrations and durability of immune response. Administration of immune globulin is warranted for selected nonimmune individuals at risk for hepatitis A exposure. Indications for each of these interventions are outlined in Table 2.
Post-exposure prophylaxis to individuals exposed to HAV consists of hepatitis A vaccine and/or immune globulin, depending on the patient characteristics (see Table 2).
| Table 2: 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 months | Healthy | No | 0.1mL/kg |
| 12 months-40 years | Healthy | 1 dose† | None |
| >40 years | Healthy | 1 dose† | 0.1 mL/kg§ |
| ≥12 months | Immunocompromised or chronic liver disease | 1 dose† | 0.1 mL/kg¶ |
| ≥12 months | Vaccine contraindicated** | No | 0.1 mL/kg |
| Preexposure protection | |||
| <6 months | Healthy | No | 0.1–0.2 mL/kg§§ |
| 6-11 months | Healthy | 1 dose¶¶ | None |
| 12 months-40 years | Healthy | 1 dose*** | None |
| >40 years | 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 months | 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 2 weeks before and 6 months after administration of IG.
† A second dose of HepA vaccine is not required for postexposure prophylaxis; however, for long-term immunity, the 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 IG administration. If the provider's risk assessment determines that both vaccine and IG are warranted, hepatitis A vaccine and IG should be administered simultaneously in a different anatomic site (eg, separate limbs).
¶ Vaccine and IG should be administered simultaneously in a different anatomic site (eg, separate limbs).
** 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 severe disease from HAV infection.
§§ 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 hepatitis A vaccine, administer dose as soon as travel is considered, and complete series according to routine schedule if the next dose is needed before travel.
††† May be administered based on provider's risk assessment.
Please contact the Acute Communicable Disease Control (ACDC) Program to report a case, obtain any other technical assistance with specimen collection or completion of forms for hepatitis A.
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Public Health has made reasonable efforts to provide accurate translation. However, no computerized translation is perfect and is not intended to replace traditional translation methods. If questions arise concerning the accuracy of the information, please refer to the English edition of the website, which is the official version.
