HepA vaccine also is indicated when any of the following is present: A desire for protection from hepatitis A in people not previously vaccinated Travel to or work in endemic areas Occupational exposure (eg, working with primates infected with hepatitis A virus [HAV] or HAV in a research laboratory) Sex between men Use of illicit drugs (injected or not), such as methamphetamine Homelessness HIV infection in all people ≥ 1 year of age A chronic liver disorder (eg, people with hepatitis B, hepatitis C, cirrhosis, fatty liver disease, alcohol-related liver disease, autoimmune hepatitis, or alanine aminotransferase [ALT] or aspartate aminotransferase [AST] level greater than twice the upper limit of normal) Anticipated close personal contact (eg, as members of the household or as regular babysitters) with an adopted child during the first 60 days after the child's arrival in the US from an endemic area Healthy adults ≤ 40 years who have recently been exposed to hepatitis A virus and adults > 40 if hepatitis A immunoglobulin cannot be obtained Pregnant women who are identified to be at risk of HAV infection during pregnancy (eg, women who are international travelers, who use illicit drugs [injected or not], who have occupational exposure risk, who anticipate close personal contact with an international adoptee, or who are homeless) or who are at risk of having a severe outcome resulting from HAV infection (eg, women who have chronic liver disease or HIV infection) During hepatitis A outbreaks, people ≥ 1 year of age who are at risk of HAV infection should be vaccinated.