Are people with developmental disabilities at risk of hepatitis A virus (HAV) infection?

Historically, HAV infection was highly endemic in institutions for people with developmental disabilities as a result of poor hand hygiene, close living conditions and diaper use. As fewer children have been institutionalized and as conditions in institutions have improved, the incidence and prevalence of HAV infection have decreased, although outbreaks can occur in these settings. All children with developmental disabilities should receive HepA vaccine according to U.S. routine vaccine recommendations, including catch up vaccination of all children through age 18 years.

As a strategy to further reduce the risk of hepatitis A outbreaks and reach adults in settings with a high proportion of people with risk factors for HAV infection, the current ACIP recommendations suggest considering HepA vaccination of residents and staff in facilities where hygiene is difficult to maintain, such as group homes for people with developmental disabilities and homeless shelters.