There are two hepatitis A vaccines; both provide long-term protection against hepatitis A.
For more information, see Hepatitis A Advisory Committee on Immunization Practices Vaccine Recommendations and Centers for Disease Control and Prevention (CDC): Hepatitis A Vaccination.
(See also Overview of Immunization.)
Preparations of Hepatitis A Vaccine
Hepatitis A (HepA) vaccines are prepared from formalin-inactivated, cell culture–derived hepatitis A virus. Both vaccines are available in pediatric and adult formulations.
Indications for Hepatitis A Vaccine
CDC: Child and Adolescent Immunization Schedule by Age).
HepA vaccine also is indicated when any of the following is present (see CDC: Adult Immunization Schedule by Age):
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
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 United States 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.
Contraindications and Precautions for Hepatitis A Vaccine
The main contraindication for HepA vaccine is
A severe allergic reaction (eg, anaphylaxis) after previous dose or to a vaccine component
The main precaution with HepA vaccine is
Moderate or severe illness with or without a fever (vaccination is postponed until the illness resolves)
Dose and Administration of Hepatitis A Vaccine
The HepA vaccine dose is 0.5 mL IM up to age 18 years or 1 mL IM for adults (age ≥ 19 years).
Children are given a 2-dose series typically at age 12 to 23 months and 6 to 18 months after the first dose.
Depending on the manufacturer, adults are given the vaccine in a 2-dose series at 0 and 6 to 12 months (Havrix) or 0 and 6 to 18 months (Vaqta).
Or adults may be given the combination HepA and HepB vaccine on a 3-dose schedule: at 0, 1, and 6 months. The first and second doses should be separated by ≥ 4 weeks, and the second and third doses should be separated by ≥ 5 months. Alternatively, the vaccine may be given on an accelerated 4-dose schedule: on days 0, 7, and 21 to 30, followed by a booster 12 months after the first dose.
Adverse Effects of Hepatitis A Vaccine
No serious adverse effects have been reported.
Mild effects include pain, erythema, swelling, and occasionally induration at the injection site.
More Information
The following English-language resources may be useful. Please note that THE MANUAL is not responsible for the content of these resources.
Advisory Committee on Immunization Practices (ACIP): Hepatitis A ACIP Vaccine Recommendations
Centers for Disease Control and Prevention (CDC): Hepatitis A Vaccination: Information for Healthcare Providers
European Centre for Disease Prevention and Control (ECDC): Hepatitis A: Recommended vaccinations
