Hepatitis A vaccine (CPT codes 90632, 90633, 90634)

Hepatitis A is an acute, usually self-limiting infection of the liver caused by hepatitis A virus (HAV).
The virus has a worldwide distribution and causes about 1.5 million cases of clinical hepatitis each year.

The disease burden due to hepatitis A in the United States has been estimated to be approximately
143,000 infections per year, of which 75,800 result in clinical hepatitis.
Humans are the only reservoir of the organism. Transmission occurs primarily through the fecal-oral
route, and is closely associated with poor sanitary conditions. The most common modes of transmission
include close personal contact with an infected person and ingestion of contaminated food and water.
The virus is shed in the feces of persons with both asymptomatic and symptomatic infection. Under
favorable conditions HAV may survive in the environment for months. Blood born transmission of
HAV occurs, but is much less common.
The average incubation period is 28 days, but may vary from 15-50 days. Approximately 10-12 days
after infection the virus can be detected in blood and feces. In general, a person is most infectious from
14-21 days before the onset of symptoms, through 7 days after the onset of symptoms. Once a person
has had Hepatitis A they have lifetime immunity so vaccines are unnecessary for these individuals.
Hepatitis A Vaccine will be covered for those patients who have been exposed either by close personal contact with an infected person or after ingestion of contaminated food or water.

Several vaccines against hepatitis A are now available that are highly efficacious and provide long-
lasting protection in adults and in children above one to two years of age.

For those requiring both immediate and long-term protection, the vaccine may be administered
concomitantly with IG.

Immunization for adults, children and adolescents consists of a two-dose regimen with the second dose
being administered 6-18 months later depending on the vaccine used.

Examples of the vaccines available are:
HAVRIX® (Hepatitis A Vaccine, Inactivated)
AQTA® (Hepatitis A Vaccine, Inactivated)