Hepatitis A Vaccination

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C All susceptible travelers who plan to depart for an area endemic for hepatitis A in less than 2 weeks should receive immune globulin as well as hepatitis A vaccine.

This answer is incorrect. Historically, the Advisory Committee on Immunization Practices (ACIP) recommended administering hepatitis A vaccination to susceptible travelers at least 2-4 weeks before departure to endemic areas. Travelers who were leaving in less than 2 weeks were advised to receive immune globulin for short-term protection. However, based on data that showed comparable postexposure efficacy of vaccine and immune globulin among healthy persons aged 1-40 years, a single-dose of vaccine administered before departure is now considered adequate protection for most healthy persons. Those travelers departing in less than 2 weeks who should receive immune globulin include persons at risk for severe hepatitis A: adults older than 40 years such as our patient and persons with chronic liver disease or other chronic medical conditions.

A Prevaccination testing for anti-HAV antibodies should be considered given her age and history of residence in an endemic region.
B All persons employed in child care centers should be vaccinated for hepatitis A.
D Hepatitis A vaccination is recommended only if the patient is expected to travel to a rural region with poor hygienic conditions.

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