Serological testing for hepatitis A immunity is not routinely recommended, but may be appropriate for some people

Serological testing for immunity to hepatitis A is not routinely recommended before receiving hepatitis A vaccine.

It is also inappropriate to test people who cannot remember whether they have ever had a hepatitis A vaccine. If a person is recommended for vaccination and has no records of previous vaccination, they should receive a vaccine.

However, certain groups of people should be screened for natural immunity to hepatitis A to avoid unnecessary vaccination:

• people who were born before 1950
• people who spent their early childhood in hepatitis A–endemic areas
• people with an unexplained previous episode of hepatitis or jaundice

People with unexplained jaundice should also be tested for other causes of hepatitis, including hepatitis B.

These people may need to be tested for total hepatitis A antibodies or IgG antibodies against hepatitis A virus. A positive test indicates immunity to hepatitis A. People who are immune do not need hepatitis A vaccination.

To better interpret serological testing results, discuss them with the laboratory that performed the test. Ensure that the laboratory receives the relevant clinical information.

Serological testing to assess immunity after vaccination against hepatitis A is neither necessary nor appropriate. This is because, even in persons who are likely immune, antibody titres are often below the detection limits of the routinely available commercial tests for antibodies against hepatitis A virus.⁷