Hep A Vaccine Group Evaluation and Forecasting Rules

General Rules for Hep A

General rules are not series-specific; general rules apply to the entire vaccine group.

Rules Based on Patient's Age

  • If a patient is >= 19 years of age and did NOT receive a shot of Hep A, then the Recommendation is Conditional and the reason code is HIGH_RISK.
  • Shots administered to a patient who is >= 19 years of age will continue to be evaluated and, if valid, will count toward completion of the series.

Proof of Immunity Rules

  • If a patient has immunity (reported as having a positive titer or serology) vaccine is not recommended.
  • Any shot administered prior to the date of immunity is evaluated as Valid or Invalid, based on minimum age and minimum interval rules.
  • Any shot administered on or after the date of immunity is evaluated as Accepted with a reason code of PROOF_OF_IMMUNITY; Recommendation is Not Recommended and the reason code is PROOF_OF_IMMUNITY.

Hep A Vaccines

CVX Code

Name

83Hep A, ped/adol, 2 dose
84Hep A, ped/adol, 3 dose

31

Hep A, pediatric, unspecified formulation 
52Hep A, adult
85Hep A, unspecified formulation

Combination Vaccines that Include Hep A 

CVX Code

Vaccine Name

Component
CVX Code

Component
Vaccine Name

104

Hep A-Hep B (Twinrix)

83

Hep A peds/adol, 2 dose

Immunization Series and Selection Rules

Series Name

  • Hep A (child/adult) 2-dose Series
  • Hep A Adult 3-dose Series1,2

Series Selection Rules

The Hep A 3-dose series applies only if one of the following is true:

  1. CVX 83 (Hep A, ped/adol, 2 dose) or CVX 84 (Hep A, ped/adol, 3 dose) or CVX 31 (Hep A, pediatric, unspecified formulation) is given to a patient >= 19 years old as dose 1 or dose 2 2, 3
  2. Dose 2 is given > = 24 days and < 6 months - 4 days from dose 1 and is given to a patient > = 18 years old.3

Otherwise, the Hep A 2-dose series applies.


Notes

  • 1The Hep A adult 3-dose series is used to accommodate Twinrix administered to patients > = 18 years of age. 
  •  2CVX 83, 84, and 31 are pediatric formulations and, therefore, when given to an adult, 3 doses are required for immunity.
  • 3An invalid shot will not cause ICE to switch the patient to a different series (i.e., if dose 1 = CVX 83 at 18 years - 1 day, shot 2 = CVX 83 at 18 years (invalid/below minimum interval), recommend dose 2 based on the 2-dose series). 
  • There is a 4-dose Twinrix series (as well as a 4-dose Hep B series) that is an accepted, accelerated schedule (used often at treatment facilities). The ICE Workgroup determined the 4-dose series is for special use and, therefore, not needed for ICE.

Immunization Series: Hep A (Child/Adult) Series

The Hep A (child/adult) series is complete after 2 doses.

Vaccine Dose Parameters - Minimum and Routine Ages

Dose

Series Name

Absolute Minimum
 Age

Minimum Age

Routine
Age 

Latest Recommended Age

(less than)

Valid CVX Code(s) per Dose for this SeriesInvalid CVX Code(s) per Dose for this Series

1

Hep A (Child/Adult)

1 year - 4 days

1 year

1 year

24 months + 4 weeks83, 84, 31, 52, 85, 104N/A
2 Hep A (Child/Adult)
18 months - 4 days18 months
18 months24 months + 4 weeks 83, 84, 31, 52, 85, 104N/A

Vaccine Dose Parameters - Minimum and Recommended Intervals

Doses

Series Name

Absolute Minimum Interval

Minimum Interval

Recommended Interval

Latest Recommended Interval

(less than)

Dose 1 to 2

Hep A (Child/Adult) 

6 months - 4 days

6 months
6 months19 months + 4 weeks


Series Special Rules 

  • Target dose 2 will be evaluated as valid if administered >= 6 months from dose 1, even if there have been invalid shots administered. 
    • Example: If dose 1 is administered at 1 year, invalid shot 2 is administered at 1 year 5 months, and target dose 2 is administered at 1 year 6 months, then target dose 2 is evaluated as valid and counts as dose 2, completing the 2-dose series.

 

Immunization Series: Hep A Adult 3-dose Series

The Hep A Adult 3-dose series is complete after 3 doses.

Vaccine Dose Parameters - Minimum and Routine Ages 

Dose

Series Name

 Absolute Minimum
Age1 

Minimum Age

Routine
Age

Latest Recommended Age

(less than)

Valid CVX Code(s) per Dose for this SeriesInvalid CVX Code(s) per Dose for this Series

1

Hep A Adult 3-dose

18 years

18 years

N/A

N/A83, 84, 31, 52, 85, 104N/A

2

Hep A Adult 3-dose

N/A

N/A

N/A

N/A83, 84, 31, 52, 85, 104N/A

3

Hep A Adult 3-dose

N/A

N/A

N/A

N/A83, 84, 31, 52, 85, 104N/A

 Vaccine Dose Parameters - Minimum and Recommended Intervals

Doses

Series Name

Absolute Minimum Interval

Minimum Interval

Recommended Interval

Latest Recommended Interval

(less than)

Dose 1 to 2

Hep A Adult 3-dose

24 days

28 days

28 days

N/A

Dose 2 to 3

Hep A Adult 3-dose

5 months - 4 days

5 months

5 months

N/A


Series Special Rules 

  • There are no special rules for this series.  


Notes

  • 1Absolute minimum age in the table above does not include a 4-day grace period; it represents the minimum age for this series.