Doctors call for children in Spain to be vaccinated against hepatitis A in light of alarming rise in cases

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Cases among children under 15 have multiplied sixfold in Malaga province over the last five years

José Antonio Sau

Monday, 12 January 2026, 10:35

The rise of hepatitis A among the children of Malaga province and Spain as a whole has become a cause for concern. Paediatricians from the vaccines and immunisations advisory committee of the Spanish paediatrics associations (CAV-AEP) are calling for the inclusion of the vaccine for babies from 12 to 15 months of age, as well as for all other unvaccinated children, in the calendar.

In the past five years, the number of cases in children under 15 years of age in the province has risen more than six times (6.33). Three cases were detected in 2020, compared to 19 in 2025. The year-on-year increase between 2024 and 2025 is 171.4% (there were seven cases in 2024).

In Andalucía, between 2020 and 2025, there has been an increase from eight to 64 cases in children under 15, representing a 700% increase, according to data from the regional 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 faecal-oral route, mainly through contaminated water or food or through close contact with an infected person. In children, it is usually mild or asymptomatic. Head of paediatrics at HM Hospitales in Malaga says that the disease is most often caused by eating contaminated food and usually presents with jaundice (yellowing of the skin and eyes due to excess bilirubin in the blood), acholia (white or pale stools), very dark urine, abdominal pain, low-grade fever, very poor general health and "excessive tiredness".

Hepatitis A is usually more severe in adults than in children, with more pronounced symptoms. "The infection can last quite a long time, depending on the degree of liver damage. It can lead to inflammation when jaundice damages the liver and transaminases, which are liver enzymes, increase. According to Dr González, the infection can last two, three or four weeks. She says that complete rest is necessary to avoid liver complications. "If the liver is very inflamed, there may be bruising, ruptures, etc., in addition to significant pain," the doctor says.

Moreover, there is no treatment beyond complete rest and fighting any specific complications that may arise.

Why are cases rising?

Why have cases increased across the country in both children and adults? Dr González says that cases of this disease have not been observed in years, which has naturally led to more lax measures. A person with hepatitis A can contaminate any food they touch and, therefore, spread the disease. The fundamental recommendation is to wash fruit and food thoroughly. To this we should add that "more and more people" refuse to get vaccinated against all sorts of diseases. Moreover, the infection can be brought into the country by foreigners.

The current increase can be attributed to low vaccination rates among children and the fact that the vaccine is not added to the protocol. Until now, people travelling to certain countries made up one of the groups subject to vaccination.

Furthermore, when the virus recirculates more intensely in the general population, children act as a vulnerable and exposed group, from which the spread extends to families, schools and communities. Transmission occurs more easily among the youngest members of society due to children having less developed hygiene habits.

It is important to note that, considering that cases in children are often milder, higher incidence can be attributed to improved epidemiological detection. In addition, there has been greater surveillance following the sharp national upturn.

Furthermore, children's natural exposure to the virus has decreased significantly in recent decades, which has reduced immunity, making contagion even easier.

Dr González says that, given the very low presence of hepatitis A in the recent past, some cases now have to be treated in emergency departments.

Hepatitis A can cause clotting disorders and risk of bleeding. The good news is that this type of hepatitis is not chronic and most children recover in just a few weeks, becoming immune for life. The alarming detail here is that they can transmit the virus without knowing it. If adults contract it, they can need up to two months to recover, which means that they cannot go to work during this time.

Although it is rare, the risk of complications increases with age, even more so in people with pre-existing liver disease, which is why vaccination is key to protecting children and adults.

The regional ministry of health states that "the hepatitis A vaccine is not currently included in the vaccination schedule. However, when an outbreak is declared, the protocol is followed, which, among other measures, includes vaccinating close contacts".

In reality, only Catalonia, Ceuta and Melilla include routine vaccination against hepatitis A. "Until now, Spain was a country with low endemicity of hepatitis A, so vaccination was recommended only for risk groups, with these three exceptions," CAV-AEP coordinator Dr Francisco Álvarez says. "However, the increase in cases in the last two years in most regions is forcing us to strengthen epidemiological surveillance and enhance prevention through vaccination," he states.