Recommendations of the Advisory Committee on Immunization Practices for use of hepatitis A vaccine for persons experiencing homelessness.
Open accessAbstract
Hepatitis A (HepA) vaccination is recommended routinely for children at age 12-23 months, for persons who are at increased risk for hepatitis A virus (HAV) infection, and for any person wishing to obtain immunity. Persons at increased risk for HAV infection include international travelers to areas with high or intermediate hepatitis A endemicity, men who have sex with men, users of injection and noninjection drugs, persons with chronic liver disease, person with clotting factor disorders, persons who work with HAV-infected primates or with HAV in a research laboratory setting, and persons who anticipate close contact with an international adoptee from a country of high or interme-diate endemicity (1-3). Persons experiencing homelessness are also at higher risk for HAV infection and severe infection-associated outcomes. On October 24, 2018, the Advisory Committee on Immunization Practices (ACIP)* recommended that all persons aged 1 year and older experiencing homelessness be routinely immunized against HAV. The ACIP Hepatitis Vaccines Work Group conducted a systematic review of the evidence for administering vaccine to persons experiencing homelessness, which included a set of criteria assessing the benefits and adverse events associated with vaccination. HepA vaccines are highly immunogenic, and >95% of immunocompetent adults develop protective antibody within 4 weeks of receipt of 1 dose of the vaccine (1). HAV infections are acquired primarily by the fecal-oral route by either person-to-person transmission or via ingestion of contaminated food or water. Among persons experiencing homelessness, effective implementation of alternative strategies to prevent exposure to HAV, such as strict hand hygiene, is difficult because of living conditions among persons in this population. Integrating routine HepA vaccination into health care services for persons experiencing homelessness can reduce the size of the at-risk population over time and thereby reduce the risk for large-scale outbreaks.
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Other infection sources identified in the United States include MSM; persons who use injecting drugs; sexual and household contacts; those experiencing homelessness; international travelers; those with children attending a nursery, childcare, or preschool; and persons working in such settings.
“Other infection sources identified in the United States include MSM; persons who use injecting drugs; sexual and household contacts; those experiencing homelessness; international travelers; those with children attending a nursery, childcare, or preschool; and persons working in such settings (13,372).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [13]
The paper’s opening summary identifies men who have sex with men, people who use injection drugs, travelers to areas with high or intermediate hepatitis A endemicity, and people experiencing homelessness as groups at increased risk. The Introduction also describes U.S. outbreaks involving homelessness and drug use. Our copy does not identify sexual or household contacts, or people with children in nursery, childcare, or preschool and staff in those settings, as infection sources. (LLM, conf=0.87)
Experimental — accuracy not yet measuredAmong cases with a risk factor identified, a recognized foodborne or waterborne outbreak was the most commonly identified risk (49.6%).
“Among cases with a risk factor identified, a recognized foodborne or waterborne outbreak was the most commonly identified risk (49.6%).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [13]
The Introduction discusses hepatitis A transmission through contaminated food or water and reports recent person-to-person outbreaks, but it does not rank identified risk factors among cases. Searches for “49.6%” and “recognized foodborne or waterborne outbreak” found no passage supporting the claimed percentage or ranking. (LLM, conf=0.75)
Experimental — accuracy not yet measuredIn the United States, of the hepatitis A cases accompanied by risk information, a particular risk was identified among only 23.8%.
“In the United States, of the hepatitis A cases accompanied by risk information, a particular risk was identified among only 23.8% (13,372).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [13]
The Introduction reports U.S. hepatitis A outbreak counts for 2017 and 2018, but not the proportion of cases with risk information for which a particular risk was identified. Searches for 23.8% and 13,372 found no matching passage in our copy. (LLM, conf=0.76)
Experimental — accuracy not yet measured
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- Authors
- Doshani, M., Weng, M., Moore, K. L., Romero, J. R., & Nelson, N. P.
- Affiliations
- Arkansas Children's Hospital (US)
- Corresponding author
- Doshani, Mona
- Venue
- MMWR Morbidity and Mortality Weekly Report
- Published
- 2019-02-15
- Volume
- 68
- Issue
- 6
- Pages
- 153-156
- ISSN
- 0149-2195 (ISSN-L)
- 1545-861X
- PMC
- PMC6375653
- OpenAlex
- W2914508593
- Cited by
- 75
- References
- 12
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 3 · 2023: 10 · 2022: 4 · 2021: 13 · 2020: 26 · 2019: 13 · 2015: 1
- FWCI
- 8.92
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- MMWR Morbidity and Mortality Weekly Report (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Hepatology › Hepatitis Viruses Studies and Epidemiology
- Social Sciences › Health › Vaccine Coverage and Hesitancy
- Health Sciences › Medicine › Infectious Diseases › Viral gastroenteritis research and epidemiology
- Keywords
- hepatitis A vaccine, hepatitis A virus, homelessness, Advisory Committee on Immunization Practices recommendations, routine immunization, vaccine immunogenicity, vaccine adverse events, hepatitis A prevention, outbreak prevention, integrated care
- MeSH terms
- Centers for Disease Control and Prevention, U.S., Hepatitis A, Ill-Housed Persons, Humans, Immunization, United States, Hepatitis A Vaccines, Advisory Committees
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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