Lorraine Williamson
Hepatitis A is not the headline infection most parents worry about in Spain. For years, it sat in the “low risk” column, with vaccination largely reserved for specific groups and situations. But paediatricians now say the country’s changing case pattern has caught up with that old assumption — and they want the Hepatitis A vaccine Spain debate settled with a nationwide child programme.
The Spanish Association of Paediatrics (AEP), through its vaccine advisory committee (CAV-AEP), has published its recommended 2026 immunisation schedule and is calling for routine hepatitis A vaccination for all children: a single dose at 12–15 months, plus catch-up (“rescue”) vaccination for older children and teenagers who have not had it.
From “low endemic” to a patchwork that no longer fits
Until now, hepatitis A vaccination has been included in the routine child schedule only in Catalonia, Ceuta and Melilla — the latter two linked to geography, and Catalonia following a pilot that became permanent. The AEP says rising cases across most regions over the past two years mean Spain should strengthen prevention and surveillance nationally.
The wider European context matters too. ECDC has tracked spikes and cross-border outbreaks in recent seasons, and has repeatedly stressed the value of targeted vaccination and rapid response measures, including vaccinating close contacts after exposure.
Hepatitis A infections on the rise across Spain
Why one dose — and why “after exposure” matters
Hepatitis A spreads mainly through the faecal–oral route, typically via contaminated food or water, or close personal contact where hygiene breaks down.
What makes the AEP proposal particularly practical is the vaccine’s usefulness even when time has already started ticking. Evidence-based guidance from public health bodies notes that vaccination can still prevent infection if given soon after exposure (ECDC notes up to about 10 days; CDC guidance commonly uses a 2-week window). That supports the AEP’s push for catch-up vaccination across childhood and adolescence.
Flu for every child, too: a broader rethink of “routine” protection
Hepatitis A is not the only area where paediatric experts want Spain to widen its safety net. The AEP also backs seasonal flu vaccination for all children and adolescents aged 6 months to 17 years, pointing to the wider benefit of reducing transmission at home and in classrooms — especially around babies under six months and people living with chronic conditions.
For families, it’s part of a bigger trend: respiratory seasons have become more unpredictable, and childhood vaccination is increasingly framed not just as individual protection, but as keeping pressure off primary care and hospitals during winter surges.
One country, many calendars: the equity argument
The AEP’s calendar is a recommendation document and does not separate vaccines into “funded” and “not funded” categories, arguing that the point of a prevention programme is consistency, not postcode luck.
Spain does have an official, CISNS-approved “common” immunisation calendar for 2026, but it does not include routine hepatitis A vaccination for all children (it appears in risk-group schedules). That gap is the space the AEP is trying to close.
The committee is also renewing its call for a stronger national immunisation decision-making structure — and points to the need for stable financing so families are not left carrying costs when recommended vaccines sit outside the publicly funded schedule.
Internationally, this direction matches WHO’s long-running push for countries to rely on multidisciplinary expert advisory groups to produce credible, evidence-based vaccine policy and support funding decisions.
What parents should take from this right now
If you are parenting in Spain, the key point is not to self-prescribe a schedule from headlines. Regional programmes still vary, and the official calendar and the paediatric society’s recommended calendar are not always identical.
Practical steps are straightforward:
-
Check what your autonomous community currently funds and offers.
-
Ask your paediatric nurse or family doctor what applies to your child’s age and risk factors.
-
Know the basics of hepatitis A: symptoms can include fever, fatigue, nausea, abdominal discomfort, dark urine and jaundice — and medical advice is important if these appear.
A turning point for child vaccination in Spain
The push to add hepatitis A to routine childhood immunisation is, at heart, an argument about modern Spain: more mobility, more mixed exposure patterns, and a public health system that works best when prevention is consistent.
If the AEP gets its way, the Hepatitis A vaccine in Spain will move from a regional exception to a national norm — and the bigger story will be whether Spain can finally narrow the gap between what experts recommend and what families can reliably access, wherever they live.
Sources: