13. Hepatitis A - What Do the Numbers Tell Us?

So where are we? Well, this is a primary prevention disease. There are no chronic infections, so those secondary and tertiary terms don't count in terms of this disease, as part of the viral hepatitis spectrum. I think we are doing pretty well in terms of the children in the higher rate states - I put "OK" up there, we actually don't have good data in terms of vaccination coverage, but some of the surveys that have been done have shown that we are doing pretty well, but we need to keep after it. In special populations we have done very well, as I have shown with the American Indian/Alaskan native population. And should we move as the advisory committee on immunization practices suggested three-four years ago, in their 1999 recommendations - that we go to vaccinating all children, that this become a universal vaccine - well, there were some technical issues, and hopefully soon, at least we will have the technical issues taken care of in terms of an immunization schedule, and then the issue is, will we have our recommendation. But with adults, and I have tried to show you the data, we have done a very poor job. And you are going to see that adult immunization, for all diseases that go across the whole age spectrum, we have not done well with adults. So there is a gap and this is something we need to begin to address.