<P> The World Health Organization (WHO) recommends universal vaccination in areas where the diseases is moderately common . Where the disease is very common, widespread vaccination is not recommended as all people typically develop immunity through infection when a child . The Center for Disease Control and Prevention (CDC) recommends vaccinating adults who are at high risk and all children . </P> <P> Severe side effects are very rare . Pain at the site of injection occurs in about 15% of children and half of adults . Most hepatitis A vaccines contain inactivated virus while a few contain weakened virus . The ones with weakened virus are not recommended during pregnancy or in those with poor immune function . A few formulations combine hepatitis A with either hepatitis B or typhoid vaccine . </P> <P> The first hepatitis A vaccine was approved in Europe in 1991 and the United States in 1995 . It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system . In the United States it costs US $50--100 . </P> <P> Within the US, the vaccine was first phased in around 1996 for children living in high - risk areas . In 1999, it was spread to areas with elevating levels of infection . In the US today, the vaccine is strongly recommended for all children 12 to 23 months of age in an attempt to eradicate the virus nationwide . Although the original FDA license for Havrix by GlaxoSmithKline is dated in 1995, it has been in use in Europe since 1993 . </P>

When did the hepatitis a vaccine became available
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