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Stephanie R. Bialek, MD, MPH, Douglas A. Thoroughman, PhD, Diana Hu, MD, Edgar P. Simard, BS, Jody Chattin, MPH, Jim Cheek, MD, MPH and Beth P. Bell, MD, MPH

Stephanie R. Bialek is with the Division of Viral Hepatitis, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Ga. At the time of the study, Douglas A. Thoroughman was with the Division of Viral Hepatitis, National Centers for Infectious Diseases, Centers for Disease Control and Prevention and the Indian Health Service National Epidemiology Program. Diana Hu is with the Indian Health Service, Tuba City Indian Medical Center, Tuba City, Az. Edgar P. Simard and Beth Bell are with the Division of Viral Hepatitis, National Center for Infectious Diseases, Centers for Disease Control and Prevention. At the time of the study, Jody Chattin was with the Epidemiology Program Office, Centers for Disease Control and Prevention. Jim Cheek is with the Indian Health Service National Epidemiology Program, Albuquerque, NM.

Correspondence: Requests for reprints should be sent to Stephanie Bialek, Division of Viral Hepatitis, Mail Stop G-37, Centers for Disease Control and Prevention, 1600 Clifton Road, NE, Atlanta, GA 30333 (e-mail: zqg7{at}cdc.gov).

Objectives. We assessed the effect on trends in hepatitis A incidence of the 1996 recommendation for routine hepatitis A vaccination of American Indian/Alaska Native (AIAN) children.

Methods. We examined trends in hepatitis A incidence among AIAN peoples during 1990–2001 and vaccination coverage levels among children on the largest American Indian reservation.

Results. Hepatitis A rates among AIANs declined 20-fold during 1997–2001. Declines in hepatitis A incidence occurred among AIANs in reservation and metropolitan areas. Among 1956 children living on the Navajo Nation whose medical records were reviewed, 1508 (77.1%) had received at least one dose of hepatitis A vaccine, and 1020 (52.1%) had completed the vaccine series.

Conclusions. Hepatitis A rates among AIAN peoples have declined dramatically coincident with implementation of routine hepatitis A vaccination of AIAN children.

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