Pediatricians call for vaccinating children against hepatitis A due to the alarming increase in cases

It's not a trend exclusive to Malaga, but it occurs simultaneously in Andalusia and Spain, yet it has caused many experts to look with concern at what is happening with hepatitis A. In Malaga, the cases of this viral disease in children under 15 years old have multiplied by more than six (6.33) in just five years: in 2020, three cases were detected compared to 19 in 2025. The annual increase from 2024 to 2025 is 171.4% (there were seven cases in 2024). The situation is such that the Advisory Committee on Vaccines and Immunizations of the Spanish Association of Pediatrics (CAV-AEP) has recommended including the vaccine for babies from 12 to 15 months and the catch-up vaccine for the rest of the children and adolescents who are unvaccinated.

Cases are not only growing in Malaga, but the increase is general in Andalusia and Spain, where only Ceuta, Melilla, and Catalonia include the vaccine in their schedule

In Andalusia, between 2020 and 2025, the number of cases in children under 15 years old has grown from eight to 64, an increase of 700%, according to data from the Ministry of Health, Presidency, and Emergencies.

What is hepatitis A?

Hepatitis A is a viral infection that affects the liver and is transmitted via the fecal-oral route, especially through contaminated water or food or by close contact with an infected person. In children, it usually occurs in a mild form or without symptoms most of the time. The head of the Pediatrics and Pediatric Emergency Service at HM Hospitals in Malaga, María González, emphasizes that it is mostly caused by the ingestion of contaminated food and usually presents with jaundice (yellowing of the body and eyes due to an excess of bilirubin in the blood), acholia (white or pale stools), abdominal pain, low-grade fever, and very poor general condition, "an exaggerated tiredness." It also happens that urine becomes very dark, she adds.

In adults, hepatitis A tends to be more severe than in children and can last between two and four weeks

In adults, hepatitis A tends to be more severe than in children, with more pronounced symptoms. "The infection can last quite a while because it depends on the degree of liver involvement: jaundice occurs due to damage in that organ, causing inflammation, increased transaminases, which are liver enzymes. It can last two, three, or four weeks," notes Dr. González, who also indicates that absolute rest is necessary to avoid liver complications, "if the liver is very inflamed, there can be contusions, ruptures, etc., besides causing significant pain."

The issue is that there is no treatment beyond fighting the specific complications that may arise and absolute rest.

Why are cases increasing?

Why have cases increased across the country in both minors and adults? Dr. González points out that these diseases were not seen years ago "and we all relaxed a bit with the measures: if a person who has it, for example, touches some food or whatever, then it contaminates everything." The fundamental recommendation is to wash fruits and food thoroughly. To this should be added that "there are more and more unvaccinated people from more things," she notes, while explaining that people from other countries also "can bring it."

The fact is that experts refer to a greater community circulation of the virus in a context where many children were not vaccinated, as it was not part of the vaccination schedule. Moreover, when the virus circulates more intensely in the general population, minors act as a vulnerable and exposed group, which translates into more diagnoses when small family, school, or community outbreaks occur. This is compounded by better epidemiological detection, with increased surveillance following the strong national rebound and the fact that fecal-oral transmission occurs more easily in minors as they are immature in hygiene habits, especially in collective environments.

Doctors confirm that cases of hepatitis A, not seen for decades, are now beginning to be treated in hospital emergencies

Moreover, the natural exposure of children to the virus has greatly decreased in recent decades, which has reduced immunity among minors and adolescents, further facilitating contagion.

Dr. González confirms that these cases had not been seen for years and are now being treated in emergencies.

Until now, the vaccine was also given to those traveling to certain countries.

But there's more. It can cause coagulation disorders and risk of bleeding. The positive note is that this type of hepatitis is not chronic, and most minors recover in just a few weeks, remaining immunized for life, but the key here is that during the infectious phase they can transmit the virus without knowing it. In adults, sick leave can even last a couple of months. Although it is uncommon, the risk of complications increases with age, even more so in people with prior liver diseases, hence vaccination is key to protect children and adults.

The Ministry of Health, Presidency, and Emergencies indicates that the vaccine is not included in the vaccination schedule, but in the event of an outbreak, close contacts are immunized

The Ministry of Health, Presidency, and Emergencies indicates that "the hepatitis A vaccine is not currently included in the vaccination schedule. However, in the event of an outbreak, the protocol, which includes vaccinating close contacts among other measures, is followed."

Actually, only Catalonia, Ceuta, and Melilla include systematic vaccination against hepatitis A, the first on a pilot basis. "Spain, until now, was a country with low endemicity of hepatitis A, so vaccination was recommended only for risk groups, except for these three exceptions," states the coordinator of the CAV-AEP, Dr. Francisco Álvarez. "The increase in cases in these last two years in most of the autonomous communities forces us, however, to reinforce the epidemiological surveillance of this disease, as well as to strengthen prevention with vaccination," he adds.