The changing epidemiology of hepatitis A in Arizona following intensive immunization programs (1988-2007)

► We examine 20 year trends in hepatitis A transmission following mass immunization. ► Overall incidence has declined dramatically. ► Older children and adults now account for a higher burden of disease. ► The highest burden has shifted from Native Americans to Hispanics and Whites. ► Risk factors have shifted from daycare/household contacts to international travel.