Hepatitis A is not as common in the US as it is in the rest of the world, but outbreaks still occur. Until 2004 hepatitis A was the most frequently reported type of hepatitis in the US, and more common in Oregon than most other states. Unlike hepatitis B, hepatitis A is an acute infection and does not become a chronic illness.

Key Facts

  • Hepatitis A is transmitted by the fecal-oral route
  • Infected children may have no symptoms
  • Routine vaccination has dramatically decreased the incidence of disease in the US

Did You Know?

Hepatitis A, hepatitis B and hepatitis C are diseases caused by three different viruses. Although each can cause similar symptoms, they have different modes of transmission and may affect the liver differently. –Vaccines.gov

What is hepatitis A?

Hepatitis A is a contagious liver disease caused by the hepatitis A virus (HAV). HAV infection is acquired primarily by the fecal-oral route (ingestion of something that has been contaminated with the feces of an infected person) from either person-to-person contact, ingestion of contaminated food or water, or contact with contaminated objects. It only takes a microscopic amount to spread the disease.

Some people when infected with HAV have no symptoms or signs of illness. This is especially true of children. The most common symptoms of the disease are: fever, tiredness, loss of appetite, nausea/vomiting, joint pain, abdominal pain, dark urine and jaundice (a yellowing of the skin or eyes). The severity of an infection can vary from a mild illness lasting a few weeks, to a more severe case which can last several months and require hospitalization.

Hepatitis A spreads differently than hepatitis B which is transmitted through blood and body fluids.

If you get hepatitis the old fashion way, i.e., you get sick from natural exposure, you have lifelong immunity. But we don’t recommend that route. It’s not a good time.

Hepatitis A

The Vaccine

The hepatitis A vaccine was introduced in 1995 and recommended for routine vaccination of children 2 and older in 1999. Because there was such a marked decrease in cases after the vaccine was implemented (see chart), in 2005 it was recommended that all children ages 12 to 23 months be vaccinated.

Getting hepatitis A vaccine is much safer than getting the disease. But like any medications, an allergic reaction or adverse side effects may occur.

Adverse reactions to the vaccine include:

  • Soreness at injection site (about 1 out of 2 adults, and up to 1 out of 6 children)
  • Headache (about 1 out of 6 adults and 1 out of 25 children)
  • Loss of appetite (about 1 out of 12 children)
  • Tiredness (about 1 out of 14 adults)

If these problems occur, they usually last 1 or 2 days.

A serious allergic reaction is very rare but may occur within a few minutes to a few hours after the shot. –CDC

Did You Know?

In 1989 the estimated annual US total cost of hepatitis A was more than $200 million. –CDC

Common Misconceptions

Hepatitis A vaccine is not necessary for young children.

“Children play an important role in HAV transmission. Children generally have asymptomatic or unrecognized illnesses, so they may serve as a source of infection, particularly for household or other close contacts.” –CDC, Pink Book

In the past, children ages 2 to 18 had the highest rates of HAV. However, since routine use of the vaccine began, these rates are much lower and incidence is now similar across all age groups.

You only need the vaccine if you are traveling.

Getting the hepatitis A vaccine before you travel is an excellent idea whether you are an adult or a child. However, we often forget diseases can sometimes come to us easier than we can go to them.

I only eat locally grown fruits and vegetables so I’m not at risk.

Most people don’t eat “only” local foods. Due to advances in agriculture, technology and food transportation, our food market is truly a global one. Food grown all over the world enters the US in a relatively short time. This leaves us at risk for foodborne pathogens, like HAV, which may be present due to unregulated and unsafe food practices in other countries or even unidentified cases in the US.

And the majority of people, even those with preferences for eating only local food, will come into contact with food which is grown and processed elsewhere at some point. If people stop vaccinating we will see more cases of hepatitis A in the US, and our chances of contracting the disease from locally grown foods will increase as more people are able to spread the disease.

I carefully wash my hands and all my fresh foods so I’m not at risk.

While that is an excellent, necessary practice, you can’t always control who else will touch your food. Young children in preschools may be silent carriers and may spread hepatitis A to your child’s food. Sounds icky, but it is realistic.

Bringing It Home

We support eating local and eating organic. But kids still need to get the hepatitis A vaccine especially in places where we have a significant number of unvaccinated children.

And…coming to an organic food near you!

“As of September 20, 2013, 162 people have been confirmed to have become ill from hepatitis A after eating ‘Townsend Farms Organic Antioxidant Blend’ in 10 states: Arizona, California, Colorado, Hawaii, New Hampshire, New Jersey, New Mexico, Nevada, Utah and Wisconsin.”

162 people were affected, almost half were hospitalized, and of the 11 children who became ill…none were vaccinated. –CDC

Remember, only some people infected with hepatitis A will have symptoms, while others with no obvious symptoms are still able to transmit the disease.


CDC, Pink Book