Evolving Characteristics of Decedents With Hepatitis A Listed as a Cause of Death, United States, 2011–2021

ABSTRACT

Hepatitis A is a vaccine‐preventable disease that typically causes mild illness. Hepatitis A outbreaks associated with person‐to‐person transmission have been widespread in the United States since 2016. We used public‐use US Multiple Cause of Death data to compare characteristics and listed comorbidities among decedents with hepatitis A‐listed deaths during non‐outbreak (2011–2015) and outbreak (2017–2021) periods and assessed the median age at death among decedents with and without hepatitis A‐listed deaths during the outbreak period. From the non‐outbreak period to the outbreak period, hepatitis A‐listed deaths more than doubled (from 369 to 801), while the hepatitis A‐listed age‐adjusted mortality rate increased 150% (p < 0.001). When compared with the non‐outbreak period, hepatitis A‐listed decedents during the outbreak period were more frequently male, aged 18–49 years, non‐Hispanic White, died in an inpatient setting, and had hepatitis A listed as their underlying cause of death. The median age at death for hepatitis A‐listed decedents was significantly younger during the outbreak period overall and among females (62 and 66 years, respectively) compared with the non‐outbreak period (64 and 72 years, respectively, p < 0.001). During the outbreak period, median age at death for hepatitis A‐listed decedents was 14 years younger than decedents without hepatitis A listed. Compared with the general US population, decedents with hepatitis A listed on the death certificate died at younger ages during 2017–2021. Efforts are needed to improve hepatitis A vaccination coverage among adults recommended for hepatitis A vaccination to prevent additional premature hepatitis A deaths.