Hepatitis A vaccination coverage among children aged 24-35 months--United States, 2004-2005.

After the licensure of hepatitis A vaccine in 1995 for children aged > or =24 months, the Advisory Committee on Immunization Practices (ACIP) incrementally expanded the proportion of children for whom it recommended the vaccine. In 1996, ACIP recommended vaccinating children in communities that had high rates of hepatitis A virus (HAV) infection, including American Indian/Alaska Native (AI/AN) communities and selected Hispanic and religious communities. In 1999, ACIP extended the recommendation to include routine vaccination for all children living in states, counties, and communities with incidence rates twice the 1987-1997 national average of 10 cases per 100,000 population (i.e., > or =20 cases per 100,000 population); ACIP also recommended considering vaccination for children living in states, counties, and communities with incidence rates exceeding the 1987-1997 national average (i.e., >10 to <20 cases per 100,000 population). National estimates of hepatitis A vaccination coverage were first made available through the 2003 National Immunization Survey (NIS), which indicated an overall national 1-dose coverage level of 16.0% (range: 6.4%-72.7%) among children aged 24-35 months. The estimates in this report update those findings by including 2 additional years of data (2004 and 2005). National 1-dose vaccination-coverage levels among children aged 24-35 months increased from 17.6% in 2004 to 21.3% in 2005. Coverage in states where vaccination was recommended (overall in 2005: 56.5%; range: 12.9%-71.0%) was below those for other recommended childhood vaccinations, such as varicella (87.5% in 2004). Despite low hepatitis A vaccination-coverage levels compared with other recommended childhood vaccinations, incidence of acute HAV infections have declined to the lowest level ever recorded. The 2005 licensure of the hepatitis A vaccine for use in younger children (aged > or =12 months) and the 2006 ACIP guideline for routine hepatitis A vaccination of all children aged > or =12 months should result in improved vaccination coverage and further reductions in disease incidence.