Recommendation for Immunization:
This immunization is recommended for all children ages 12 months to 18 years and all adults with risk factors. It is available for other adults who desire the vaccine. A second or "booster" shot is given 6-18 months after the first shot (Vaqta® 6-18 months; Havrix® 6-12 months). Risk factors for Hepatitis A include: household and sexual contacts of infected people, men who have sex with men, drug users (intravenous and non-intravenous), chronic liver disease, people who receive clotting factor concentrates, some people working in child day-care centers or caring for institutionalized patients (data varies, maybe only if outbreak known), people working with the virus or with non-human primates, military personnel, people living in or travelling to areas with high infection rates some of which include Africa, Asia (not Japan), and the Middle-East.
Available brands of this vaccine include:
- Vaqta®
- Havrix®
- Twinrix® (combined with Hepatitis B vaccine)
1. What is this vaccine?
This is a vaccine against Hepatitis A infection.
2. Why is this vaccine important?
This vaccine aims to prevent Hepatitis A infection, a liver infection that occurred in approximately 40,000 people in the United States in 2005. The vaccine will not protect against other forms of hepatitis. It is recommended for children 12 months to 18 years old and to anyone at increased risk for Hepatitis A infection. You do not need this vaccine if you have already had Hepatitis A disease.
3. How is this vaccine given?
The deltoid muscle is the preferred site for injecting this vaccine.
4. What are the risks and special considerations of this vaccine?
People with immune problems are sometimes given the vaccine, since it is inactivated, but they may not mount a complete response. Side effects are not common but can include pain, swelling, warmth, and or redness at the injection site. Less commonly, other reactions can occur including rash and fever in 1-2 year olds; headache, sore throat or abdominal pain in older children and teens; and fatigue, fever, abdominal pain, headache, sore throat, and diarrhea in adults. Rare instances of severe reactions including Guillain-Barré have been reported. Safety in pregnancy or nursing mothers has not been established. As an alternative, adults can get a combined Hepatitis A and B vaccine (Twinrix®-GlaxoSmithKline), given in 3 doses with the second dose given 1 month after the first dose, and the third dose given 6 months after the first dose.
Most people have immunity to the Hepatitis A virus a month after the first shot, but protection is virtually 100% one month after the second shot. Post-vaccination testing for immunity is not recommended since the vaccine is so effective and testing is not always accurate.
Individuals with prior severe reactions to this vaccine may not be able to receive another dose. Check with your doctor regarding this issue and for any other contraindications for this vaccine. Also check with your doctor to find out what other ingredients may be in the vaccine, its container, or any diluent in case of allergies or other concerns. Immunization is usually postponed for individuals with a moderate or severe acute illness.
5. Risk factors for contraction of disease
- Travelers, including military personnel, to areas of substantial risk of Hepatitis A
- Men having sex with men
- Close (including sexual) contacts of infected persons
- Users of illegal drugs including non-injectable drugs
- People who receive clotting factor concentrates
- People working with the virus or with non-human primates
- People with chronic liver disease (at increased risk for liver failure if they get Hepatitis A)
Citations
- "Viral Hepatitis A Fact Sheet." National Center for HIV, STD, and TB Prevention. Centers for Disease Control. June 2008. http://www.cdc.gov/ncidod/diseases/hepatitis/a/fact.htm.
- "Viral Hepatitis." National Center for Health Statistics. Centers for Disease Control and Prevention. April 2008. www.cdc.gov/nchs/fastats/hepatits.htm.
- "Hepatitis Illnesses Hit Record Lows" WebMD®. March 2007. http://www.webmd.com/hepatitis/news/20070315/hepatitis-illnesses-hit-record-lows?src=RSS_PUBLIC.
- "Recommended Immunization Schedule for Persons Aged 0-18 Years, United States 2008." U.S. Department of Health and Human Services. Centers for Disease Control and Prevention. May 2008. http://www.cdc.gov/vaccines/recs/schedules/downloads/child/2008/08_11x17_booklet_pr.pdf.
- "Recommended Adult Immunization Schedule — United States, October 2007–September 2008." U.S. Department of Health and Human Services. Centers for Disease Control and Prevention. October 2007. www.cdc.gov/mmwr/pdf/wk/mm5641-Immunization.pdf.
- "Hepatitis A Vaccine: What You Need to Know." U.S. Department of Health and Human Services. Centers for Disease Control and Prevention. National Immunization Program Vaccine Information Statement. March 2006. http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-hep-a.pdf.
- "(Hepatitis A Vaccine, Inactivated) Vaqta®." Merck & Co., Inc. December 2007. http://www.merck.com/product/usa/pi_circulars/v/vaqta/vaqta_pi.pdf.
- "Prescribing Information Havrix® (Hepatitis A Vaccine, Inactivated)." GlaxoSmithKline. March 2008. http://us.gsk.com/products/assets/us_havrix.pdf.
- Fiore AE, Wasley A, Bell BP. "Prevention of Hepatitis A Through Active or Passive Immunization. Recommendations of the Advisory Committee on Immunization Practices (ACIP)." MMWR (Morbidity and Mortality Weekly Report. Centers for Disease Control and Prevention. May 2006. http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5507a1.htm.
- "Hepatitis A and B Vaccines." Immunization Action Coalition. November 2005. http://www.immunize.org/catg.d/p2081.pdf.
- "Twinrix® [Hepatitis A Inactivated and Hepatitis B (Recombinant) Vaccine]." GlaxoSmithKline. April 2007. http://us.gsk.com/products/assets/us_twinrix.pdf.
- "Vaccine Excipient and Media Summary." U.S. Department of Health and Human Services. Centers for Disease Control and Prevention. http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/B/excipient-table-1.pdf.
- "Vaccine Excipient and Media Summary, Part 2." U.S. Department of Health and Human Services. Centers for Disease Control and Prevention. April 2008. http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/B/excipient-table-2.pdf.
- "Thimerosal in Vaccines." Food and Drug Administration. June 2008. http://www.fda.gov/CbER/vaccine/thimerosal.htm.
Created: 7/2/2007
Last Modified: 8/7/2008