Hepatitis A is a highly contagious disease spread by close personal contact and is often transmitted by food handlers (epidemics have occurred, for example, in restaurants). Although most individuals recover without long term problems, the disease can cause children to miss several weeks of school and other activities. Rarely hepatitis A can lead to death (about 25,000 cases occur per year, and about 200 will die). Vaccination will prevent this from happening. The vaccine is very safe and is recommended for children after 12 months of age. The virus is an inactive form and safe for most persons. The primary concern with this vaccine is a reaction to a component of the vaccine.
While hepatitis A does not lead to chronic (longterm) liver disease, hepatitis B can. Hepatitis B is transmitted by blood, saliva, and other secretions; at risk groups include infants of mothers with hepatitis B, sexual partners, and those sharing needles, razors or even toothbrushes with infected individuals. Most infants who are exposed can develop chronic infection. The disease often progresses slowly, leading to liver failure in adults. Vaccination for hepatitis B has been available since 1991 and has greatly reduced the problem. Immunization begins at the time of birth. Combination vaccines with both hepatitis A and B are available for older persons who were not previously immunized.