Chloe Ramirez
Hepatitis A is a serious liver disease caused by the hepatitis A virus (HAV). The disease used to be more common in the United States, but thanks to vaccines, the number of cases has dropped by 95%. Vaccines are highly effective in preventing HAV infection and are recommended for all children between 12 months and 18 years of age living in the United States. The Advisory Committee on Immunization Practices (ACIP) recommends routine vaccination for children ages 12–23 months and catch-up vaccination for children ages 2–18 years who have not previously received the vaccine. The hepatitis A vaccine is typically given as a series of two shots, with the second shot administered at least six months after the first. This spacing between doses is important, as doses of the vaccine administered less than six months apart are considered invalid and should be repeated.
| Characteristics | Values |
|---|---|
| Hepatitis A vaccine series administered over | 6 months |
| Hepatitis A vaccine dosage | 2 doses |
| Minimum interval between doses | 6 months |
| Hepatitis A and B combination vaccine | 3 doses |
| Hepatitis A and B combination vaccine (Twinrix) | 3 or 4 doses |
| Twinrix accelerated schedule | 3 doses over 30 days, followed by a booster dose at 12 months |
| Hepatitis A vaccine for infants aged 6-11 months | 1 dose |
| Hepatitis A vaccine for infants aged 6-11 months who are travelling internationally | 1 dose before departure, followed by 2 doses (separated by at least 6 months) between age 12-23 months |
| Hepatitis A vaccine for children aged 12-23 months | 2 doses |
| Hepatitis A vaccine for children aged 2-18 years | 2 doses |
| Hepatitis A vaccine for adults | 2 doses |
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What You'll Learn
Hepatitis A vaccine schedules for children and adults
The Advisory Committee on Immunization Practices (ACIP) recommends routine vaccination for children aged 12–23 months and catch-up vaccination for children aged 2–18 years who have not previously received a hepatitis A vaccine. Hepatitis A vaccine series are typically administered over the course of 6 months, with two shots given six months apart for complete protection.
For infants aged 6–11 months, one dose is recommended before international travel, followed by two doses (separated by at least six months) between the ages of 12–23 months. Unvaccinated children over 12 months should receive their first dose as soon as travel is considered.
Children over the age of two who have not received their first dose can get it at their next doctor's visit. For children and adolescents aged 12 months to 18 years, two doses of the hepatitis A vaccine are recommended.
Adolescents aged 18 years or older may receive the hepatitis A-hepatitis B (Twinrix) vaccine as a 3-dose series (0, 1, and 6 months) or a 4-dose series (doses at 0, 7, and 21–30 days, followed by a booster dose at 12 months). Twinrix is licensed for adults 18 and older and contains the hepatitis A antigen and recombinant hepatitis B virus (HBV) surface antigen protein.
Primary vaccination with Twinrix typically involves three doses administered over a six-month schedule. However, an accelerated schedule is available for travellers, where the three doses are given over 30 days, followed by a booster dose at 12 months for long-term protection.
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Hepatitis A vaccine for international travellers
Hepatitis A is a liver disease caused by the hepatitis A virus (HAV). It is among the most common vaccine-preventable infections acquired during international travel. Travellers to countries where hepatitis A is common are at risk of contracting the infection. The risk is greater for those who live in or visit rural areas, trek in backcountry areas, or frequently eat or drink in settings with poor sanitation and limited access to clean water. Sporadic outbreaks have been reported in Australia, Europe, and North America, and other regions with low levels of endemic transmission.
The Advisory Committee on Immunization Practices (ACIP) recommends hepatitis A vaccination for unvaccinated adults who are at increased risk of infection or severe disease from infection. This includes international travellers. The hepatitis A vaccine is safe, effective, and prevents HAV infection. It confers long-term immunity, with anti-HAV persisting for at least 20 years in people who received a complete vaccine series.
The United States Food and Drug Administration (FDA) has licensed two single-antigen hepatitis A vaccines (Havrix and Vaqta) and one combination vaccine for protection against both hepatitis A and hepatitis B (Twinrix). People 12 months and older should receive two doses of the hepatitis A vaccine, typically administered over six months. The Twinrix vaccine can be administered on an accelerated schedule before travel, with three doses given over 30 days, followed by a booster dose at 12 months for long-term protection.
For infants aged 6-11 months who are travelling internationally, the CDC recommends one dose of hepatitis A vaccine before departure, followed by two doses (separated by at least six months) between the ages of 12-23 months. Unvaccinated children and adolescents aged 12 months and older should receive the first dose as soon as travel is considered.
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Hepatitis A and B combination vaccine
Hepatitis A and B are serious liver diseases caused by the hepatitis A and B viruses. Hepatitis A is less common in the US and other regions with good sanitation and waste systems. However, it is a significant health problem in parts of the world with poor sanitation. Hepatitis B is highly contagious and constantly present in much of the developing world. Both viruses can be contracted by consuming contaminated food or water, with hepatitis B also spread through contact with bodily fluids.
The hepatitis A and B combination vaccine is used to prevent infection caused by all known subtypes of the hepatitis A and hepatitis B viruses. The vaccine works by causing the body to produce antibodies against the disease. The combination vaccine is recommended for people aged 18 and above who are at an increased risk of infection. This includes travellers to certain countries or remote areas, and people at risk due to their jobs or behaviours.
The hepatitis A and B combination vaccine is typically administered as three doses over six months. An accelerated schedule is also available, with four doses over 30 days, followed by a booster dose at 12 months. The accelerated schedule may be suitable for travellers, providing long-term protection after potential exposure.
The hepatitis A and B combination vaccine is generally safe and effective, but side effects may occur. These can include mild flu-like symptoms and, rarely, serious allergic reactions. It is important to consult a healthcare professional to weigh the risks and benefits of the vaccine and ensure it is suitable for an individual's specific needs.
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Twinrix vaccine and its accelerated schedule
Twinrix is a combination vaccine that guards against hepatitis A and hepatitis B. It is licensed for adults 18 and older and contains the HAV antigen and recombinant hepatitis B virus (HBV) surface antigen protein. The Advisory Committee on Immunization Practices (ACIP) recommends hepatitis A vaccination for unvaccinated adults who are at an increased risk of infection or severe disease from infection. Hepatitis A vaccines are typically administered over six months. However, Twinrix may be administered on an accelerated schedule before travel or any other potential exposure.
The accelerated schedule for Twinrix consists of four doses. The first three doses are given over a 30-day schedule, with the fourth dose, a booster dose, given at 12 months. This booster dose provides long-term protection. The specific timing of the accelerated schedule is as follows: 3 doses at 0, 7, and 21-30 days, followed by the booster at 12 months. This schedule ensures that individuals are protected before potential exposure during travel or other activities.
The standard schedule for Twinrix is three doses at 0, 1, and 6 months. This schedule is typically followed when there is no immediate risk of exposure to hepatitis A or hepatitis B. It is important to note that the accelerated schedule should only be used when necessary, as the standard schedule is generally preferred to establish a strong immune response.
Twinrix is a safe and effective vaccine, and it is important to complete the full vaccination course to ensure protection against hepatitis A and hepatitis B. Individuals should consult their healthcare professionals to determine the appropriate vaccination schedule for their specific needs.
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Hepatitis A vaccine side effects
Hepatitis A vaccines are safe and highly effective in preventing HAV infection. The immunoglobulin G (IgG) anti-HAV produced after vaccination confers long-term immunity. The exact duration of protection is unknown, but in studies of people who received a complete vaccine series, anti-HAV has been shown to persist for at least 20 years. Scientific evidence overwhelmingly supports the safety of hepatitis A vaccines.
The common side effects are usually mild and last 1-2 days. The most common potential side effect is soreness at or around the injection site. Other potential side effects include mild headache, loss of appetite among children, and feeling tired. Children 11-25 months who received Havrix were also reported to experience irritability, drowsiness, and loss of appetite.
However, like any medicine, the vaccine could cause serious problems, such as an allergic reaction, which may appear within a few minutes or hours after getting the shot. This occurs very rarely, but if you believe you are having a reaction to the vaccine, you should call your provider right away.
People with certain medical conditions should be cautious before taking the vaccine. For example, people with an allergy to neomycin should not get the vaccine. People with bleeding problems, such as hemophilia, should use the vaccine with caution as there may be an increased risk of bleeding at the injection site. Those with a weak immune system from a disease or medicine may find that the vaccine is less effective. If a person is moderately or severely ill at the time of vaccination, they should consult their doctor first.
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Frequently asked questions
Yes, Hep A vaccines should be administered six months apart. The Advisory Committee on Immunization Practices (ACIP) recommends that the hepatitis A vaccine be given in two shots, with the second dose administered at least six months after the first.
The CDC recommends that all children between the ages of 12 and 23 months get the Hep A vaccine. Unvaccinated children between the ages of 2 and 18 years should also receive the vaccine. Additionally, adults who are at increased risk of infection or severe disease from Hepatitis A should get vaccinated. This includes individuals with risk factors such as international travel, homelessness, drug use, male-to-male sexual contact, and incarceration.
The recommended dosage schedule for the Hep A vaccine varies depending on the age group and the specific vaccine brand. For children between the ages of 12 months and 18 years, two doses of the Hep A vaccine are typically recommended. The minimum interval between the first and second doses should be at least six months. For adults aged 19 and older, two doses are also recommended, with a minimum interval of six to eighteen months between doses. In the case of the Twinrix vaccine, which is a combination vaccine for Hepatitis A and B, there is an option for a 4-dose series with doses administered at 0, 7, and 21-30 days, followed by a booster dose at 12 months.
