On February 25, 2009, the Advisory Committee on Immunization Practices (ACIP) recommended routine hepatitis A vaccination for household members and other close personal contacts (e.g., regular babysitters) of adopted children newly arriving from countries with high or intermediate hepatitis A endemicity. This new recommendation complements previous ACIP recommendations for hepatitis A vaccination for persons traveling from the United States to countries with high or intermediate hepatitis A endemicity (including persons with travel related to international adoption), and postexposure prophylaxis for contacts of persons with hepatitis A. This report introduces the new recommendation and outlines the underlying epidemiologic and programmatic rationale.