Chloe Ramirez
Hepatitis A and B are serious liver diseases that can be prevented by safe and effective vaccines. Hepatitis A is spread through infected food or water, close personal contact, or international travel to certain countries. Hepatitis B is transmitted through contact with bodily fluids, needle sharing, or mother-to-child during childbirth. Vaccines for these diseases are highly effective in preventing infection and reducing new cases. There are separate vaccines for hepatitis A and B, as well as a combination vaccine that protects against both. The hepatitis A vaccine is typically given in two doses, while the hepatitis B vaccine is usually administered in three or four doses. These vaccines are recommended for individuals at risk of infection, including international travelers, men who have sex with men, and those with chronic liver disease.
| Characteristics | Values |
|---|---|
| Hepatitis A vaccine | Safe and highly effective; prevents infection by all known subtypes of the hepatitis A virus; causes body to produce antibodies; two doses given six months apart; full protection requires two or three shots; two licensed single-antigen vaccines (Havrix and Vaqta) and one combination vaccine (Twinrix) available in the US; safe for pregnant patients at risk for HAV infection or severe outcome from HAV infection |
| Hepatitis B vaccine | Produced with recombinant DNA techniques; contains immunologic adjuvant; available separately and in combination with other vaccines; safe for use during pregnancy or while breastfeeding; does not cause Guillain-Barré syndrome; three or four doses given over a six-month period; two-dose vaccine (Heplisav-B) approved for adults 18 and older; four-dose vaccine (Twinrix) can be given on an accelerated schedule for short-notice travel |
| Hepatitis A and B combination vaccine | Recommended for all persons 18 years or older who are at risk from infection due to their jobs, behaviours, or travel to certain regions; safe and highly effective; causes body to produce antibodies |
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What You'll Learn
Hepatitis A and B vaccine side effects
Hepatitis A and B vaccines protect against liver inflammation and other symptoms caused by the viruses. They are generally safe and effective for most people. However, as with any medicine, there is a small risk of side effects. These side effects are usually mild and typically last for a day or two, but some may persist for longer and require medical attention.
Some common but mild side effects include pain at the injection site, swelling, or inflammation. These symptoms typically subside within a few days to weeks and are not cause for concern. However, if they continue for more than a week or worsen, it is recommended to seek medical attention.
One of the more severe but rare side effects is Shoulder Injury Related to Vaccine Administration (SIRVA). This occurs when the vaccine is administered too high or deep in the shoulder, causing intense shoulder pain within 48 hours of vaccination. Other severe side effects may include allergic reactions, vasovagal syncope, ADEM, and CIDP. If any severe reactions or injuries occur, it is crucial to seek immediate medical attention and, in some cases, legal advice.
It is important to note that the Hepatitis B vaccine has been studied extensively, and there is no evidence linking it to autoimmune conditions such as Multiple Sclerosis (MS), diabetes, or asthma. Additionally, the vaccine is considered safe for use during pregnancy and breastfeeding and does not increase the risk of Guillain-Barré syndrome.
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Who should get vaccinated?
Hepatitis A and Hepatitis B are serious liver diseases caused by the Hepatitis A Virus (HAV) and Hepatitis B Virus (HBV), respectively. Both diseases can cause death and are spread through infected food or water, close personal contact, blood, saliva, semen, vaginal fluids, and from mother to child. While Hepatitis A is more commonly spread in areas with poor sanitation and waste systems, Hepatitis B is more prevalent in specific countries and regions. Vaccination is the best way to protect oneself against these diseases, and there are several vaccines available for each, including single-antigen and combination vaccines.
The Hepatitis A vaccine is recommended for all children between 12 and 23 months old as part of routine childhood vaccination, and for all children and adolescents aged 2 to 18 years who have not previously received the vaccine. Additionally, the following groups are considered high-risk and should prioritise getting vaccinated:
- International travellers
- Men who have sex with men
- People who use or inject drugs
- People with jobs that increase the risk of exposure (e.g., healthcare workers)
- People anticipating close contact with an international adoptee
- People experiencing homelessness
For the Hepatitis B vaccine, the Advisory Committee on Immunization Practices (ACIP) recommends vaccination for all infants at birth, unvaccinated children younger than 19 years of age, adults aged 19-59 years, and adults 60 years and older with risk factors or seeking protection. The following groups are also recommended to receive the vaccine:
- Adults 60 years and older without known risk factors
- People with diabetes, at the clinician's discretion
- International travellers to countries with high or intermediate levels of HBV infection
- Healthcare and public safety personnel with reasonably anticipated risk of exposure to blood or blood-contaminated body fluids
- Pregnant women, given the high risk of HepB transmission to infants
- Individuals engaging in intravenous drug use or with multiple sexual partners
It is important to note that the Hepatitis A and Hepatitis B combination vaccine is only recommended for individuals aged 18 years or older. Before receiving any vaccine, individuals should consult their doctor and disclose any allergies or unusual reactions to medicines.
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How many doses are required?
The number of doses required for the Hepatitis A vaccine depends on the age of the recipient and the type of vaccine being administered. The Advisory Committee on Immunization Practices (ACIP) recommends that children between 12 and 23 months old receive a 2-dose series of the Hepatitis A vaccine, with the second dose administered 6 to 18 months after the first. For children and adolescents aged 2 to 18 years who have not previously received the vaccine, a 2-dose series is also recommended. For adults 19 years and older, a 2-dose series is typically administered, with the doses given 6 to 12 or 6 to 18 months apart, depending on the manufacturer.
Alternatively, adults may opt for the combination Hepatitis A/Hepatitis B vaccine, which is given in three doses: at 0, 1, and 6 months. The first and second doses should be separated by at least four weeks, while the second and third doses should be separated by at least five months. An accelerated 4-dose schedule is also available, with doses administered on days 0, 7, and 21 to 30, followed by a booster dose 12 months after the initial dose.
Regarding the Hepatitis B vaccine, it is typically administered as a series of two or three shots, depending on the brand. The World Health Organization (WHO) recommends a 3-dose series on a 0, 1, and 6-month schedule for maximum, long-term protection. However, alternative schedules may be considered, and some brands, such as Heplisav-B, offer a 2-dose vaccine for adults 18 and older, administered one month apart. In cases where an accelerated schedule is necessary, such as before travel, a booster dose at one year may be required to ensure long-term protection.
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How effective are the vaccines?
Hepatitis A vaccines are safe and highly effective, even for people with compromised immune systems. Vaccination is the best way to protect against hepatitis A, and cases have declined significantly since the vaccine was first recommended. The vaccine works by causing the body to produce its own protection (antibodies) against the disease. While there is a small risk that a serious problem could occur after vaccination, as with any medicine, the potential risks of hepatitis A are much higher than any risks associated with the vaccine. There have been no serious side effects from the hepatitis A vaccine, with the most common side effect being soreness in the area around the shot site.
Hepatitis A vaccines are recommended for all children 12–23 months old as part of routine childhood vaccination. All children and adolescents 2–18 years old who have not previously received the hepatitis A vaccine should also get it. Some people are at higher risk for hepatitis A and should prioritise getting vaccinated, including international travellers, men who have sex with men, people who use or inject drugs, people whose jobs increase the risk of exposure, people who anticipate close personal contact with an international adoptee, and people experiencing homelessness.
Hepatitis B vaccines are also safe and effective and are recommended for all infants at birth and for children up to 18 years. The vaccine is also recommended for adults living with diabetes and those at high risk of infection due to their jobs, lifestyle, living situations, or country of birth. Since everyone is at some risk of hepatitis B, all adults should consider getting the hepatitis B vaccine for lifetime protection against a preventable chronic liver disease. The hepatitis B vaccine is also known as the first "anti-cancer" vaccine because it prevents hepatitis B, the leading cause of liver cancer worldwide.
More than 1 billion doses of the hepatitis B vaccine have been given worldwide, and it is considered one of the safest and most effective vaccines ever made. Studies have found that immune memory against HepB is sustained for at least 30 years after vaccination, and protects against clinical disease and chronic HepB infection. Numerous studies looking at the vaccine's safety have been conducted by the World Health Organization, U.S. Centers for Disease Control and Prevention, and many different medical societies. No evidence has been found that the hepatitis B vaccine causes sudden infant deaths (SIDs), autism, multiple sclerosis, or other neurological disorders. Common side effects from the hepatitis B vaccine may include soreness, swelling, and redness at the injection site.
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How are the vaccines administered?
The Hepatitis B vaccine is an injection (or shot) that is generally given in the arm and as a three-dose series. The Advisory Committee on Immunization Practices (ACIP) recommends hepatitis B (HepB) vaccination among all infants at birth, unvaccinated children younger than 19 years of age, adults aged 19–59 years, and adults aged 60 years and older with risk factors for hepatitis B or without identified risk factors but seeking protection. The Hepatitis B vaccine can be given as a standalone vaccine or as part of a combination vaccine. The World Health Organization (WHO) recommends a pentavalent vaccine, combining vaccines against diphtheria, tetanus, pertussis, Haemophilus influenzae type B, and hepatitis B.
The Hepatitis A vaccine is administered as two or three shots, depending on the type of vaccine. Hepatitis A vaccines only protect against hepatitis A, but there are separate vaccines for hepatitis B only, as well as a combination hepatitis A and hepatitis B vaccine that protects against both viruses. The combination vaccine is recommended for all persons 18 years of age or older who are at risk from infection due to their jobs, behaviours, or travel plans. The Hepatitis A and Hepatitis B combination vaccine is safe and highly effective, even for people with compromised immune systems.
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Frequently asked questions
Hepatitis A and B are both serious diseases of the liver. Hepatitis A is usually a short-term illness that clears on its own, while Hepatitis B can become chronic and lead to serious health problems like liver damage or cancer.
Yes, the Hepatitis A and B vaccines are made from inactivated viruses, which means they cannot cause infection.
The Hepatitis A vaccine is recommended for all children and adolescents aged 12-18 who have not previously received it. It is also recommended for unvaccinated adults who are at increased risk of infection. The Hepatitis B vaccine is recommended for all infants at birth, and for adults who are at risk from infection due to their jobs, behaviours, or travel plans.
The Hepatitis A vaccine is given in two doses, six months apart. The Hepatitis B vaccine is usually given in three or four doses over a six-month period. There are also combination vaccines available that protect against both Hepatitis A and B, such as Twinrix, which is given as three or four doses.
