Hepatitis A Vaccination

Hepatitis A is an infection of the liver caused by the hepatitis A virus.

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Hepatitis A occurs worldwide, mostly in countries where sanitation is poor. It is one of the most frequent causes of foodborne infections. For travelers seeking adventure or cultural experiences in regions like India, parts of Southeast Asia, Africa, and South America, it is highly recommended to consider Hepatitis A vaccination as part of their travel preparation.

Most cases imported into Britain have been contracted in the Indian sub-continent. Outbreaks of hepatitis A infection can occur sporadically and can be explosive.


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Hepatitis A Vaccine for Travelers and Residents in High-Risk Areas

Hepatitis A is transmitted by ingesting food or water that has been contaminated with faeces.
It can also be spread directly from an infected individual through poor personal hygiene, such as lack of hand washing.The hepatitis A virus can persist in the environment and can withstand food production processes.

Symptoms

Symptoms can vary from mild disease to severe disease. The disease is more likely to be severe in older adults and people with pre-existing liver disease.

The incubation period is around 14-28 days. The virus is found in faeces during this time.

Symptoms include mild fever, nausea/vomiting, diarrhoea and abdominal pain. Jaundice may also occur. Infection with hepatitis A results in lifelong immunity.

Treatment

There is no specific treatment available for Hepatitis A.

Prevention

It is important to observe food and water hygiene while travelling. This includes only drinking bottled water, not using ice, avoiding salads and only eating food that is piping hot when served.

There is a very safe and effective vaccine against Hepatitis A.

The Hepatitis A Vaccine

It is important to observe food and water hygiene while travelling. This includes only drinking bottled water, not using ice, avoiding salads and only eating food that is piping hot when served.

 

Why get Hepatitis A vaccine?

The hepatitis A vaccine is a very safe and effective vaccine against Hepatitis A virus.

It should be considered for individuals aged 1 years and over travelling to or going to reside in countries where hepatitis A infection is prevalent.

Adult Schedule

The first dose should be given ideally 2 weeks before travel to the risk area.

Vaccine Brand Age Method of Administration Number of Doses Interval Between Doses
Avaxim From 16 years Intramuscular injection to the deltoid muscle 2 2nd dose should be given ideally 6-12 months after first. The 2nd dose can be given up to 3 years after the 1st dose.
Havrix Monodose From 16 years Intramuscular injection to the deltoid muscle 2 2nd dose should be given ideally 6-12 months after first. The 2nd dose can be given up to 3 years after the 1st dose.
Vaqta Adult From 16 years Intramuscular injection to the deltoid muscle 2 2nd dose should be given ideally 6-12 months after first. The 2nd dose can be given up to 3 years after the 1st dose.

Children’s Schedule

Vaccine Brand Age Range Method of Administration Number of Doses Interval Between Doses
Vaqta Paediatric 1-17 years Intramuscular Injection to the thigh or deltoid muscle 2 The 2nd dose should be given 6-12 months after the first dose.
Havrix Junior Monodose 1-15 years Intramuscular injection to the thigh or deltoid muscle 2 The 2nd dose should be given 6-12 months after the first dose.

Booster Doses

Further single booster doses are required after 25 years for ongoing travel risk.

Vaccine Brand Age Method of Administration Number of doses
Hepatyrix From 15 years Intramuscular injection to the deltoid muscle 1

The vaccine should not be given in the following circumstances:

  • To infants under 1 year of age.
  • There is a history of severe allergic reaction to previous dose of the vaccine or any of the components of the vaccine.
  • There is a history of severe allergic reaction to formaldehyde (a preservative) or neomycin (an antibiotic).
  • In illnesses with high fever (greater than 38.5 degrees Celsius).

Cautions

The syringe plunger stopper and tip cap contain dry natural latex rubber that may cause allergic reaction in those that are extremely hypersensitive to latex (history of anaphylaxis reaction).

Pregnancy

There is no evidence of harm from vaccinating pregnant women with inactivated vaccines. Therefore, the hepatitis A vaccine can be given during pregnancy if there is significant risk of exposure to the infection.

Breast Feeding

There is no evidence of harm from vaccinating breast feeding mothers with inactivated vaccines. Therefore, the hepatitis A vaccine can be given while breast feeding if there is significant risk of exposure to the infection.

Common Side Effects

  • Localised injection site reactions-pain, redness
  • Fever, headache, muscle ache, loss of appetite can occur, but are not common.

Interactions with Other Vaccines

The hepatitis A vaccine does not interact with other vaccines and can be given at the same time or any time before or after other vaccines including:

  • Typhoid-injection or oral vaccine
  • Hepatitis B vaccine
  • Diphtheria, Tetanus and Polio vaccine
  • Rabies vaccine
  • Yellow fever
  • Oral Cholera vaccine
  • Japanese encephalitis vaccine
  • MMR combined vaccine and other vaccines in the routine UK immunisation schedule

When travelling to areas where hepatitis A is highly prevalent, such as South Asia (specifically Bangladesh, India, Nepal, and Pakistan), Sub-Saharan and North Africa, certain regions of the Far East (excluding Japan), South and Central America, and the Middle East, it is important to take precautions.

The hepatitis A vaccine is known for its long-lasting immunity. After completing the two-dose series, most individuals have immunity that can last 20 years or more.

Studies suggest that protection might even extend to a lifetime. This extended duration of immunity makes the hepatitis A vaccine a valuable preventive measure, especially for travellers to endemic areas.

The standard hepatitis A vaccination schedule includes two doses, typically administered 6 months apart.

Once the initial series is completed, a booster is not routinely recommended as the two-dose series provides long-term protection.

This simplified schedule applies universally, regardless of the brand of the vaccine, making it easier for patients to understand and follow.

Hepatitis A risk is higher in many regions of the world, especially in areas with poor sanitation or where hepatitis A is prevalent.

This includes parts of Africa, Central and South America, Eastern Europe, Asia, and the Middle East.

Travellers to these regions should strongly consider hepatitis A vaccination for preventive health.

The cost of each Hepatitis A vaccination dose is £79. Initially, there is an additional base fee of £20.

However, for the second dose, only the vaccine cost of £79 applies, as the base fee is not charged again. Therefore, two doses are required, but the base fee is a one-time charge.

The hepatitis A vaccine is generally safe, with most side effects being mild and temporary. Common side effects include soreness at the injection site, headache, and mild fever.

Rarely, more serious side effects can occur, such as allergic reactions. It is important to discuss with your healthcare provider if you have concerns about vaccine side effects.

Our medical staff will also be there to support you during and after the vaccination.

What are the symptoms of hepatitis A?

The symptoms of hepatitis A can vary and may include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, clay-colored bowel movements, joint pain, and jaundice (yellowing of the skin and eyes).
Symptoms typically appear 2-6 weeks after infection and can last up to 2 months. It’s important to note that not everyone, especially children, may show symptoms.

Can children have the hepatitis A vaccine?

Yes, children can receive the hepatitis A vaccine. In fact, it is routinely recommended for children aged 1 year or older.
The vaccine provides effective protection against hepatitis A and is generally included in the childhood vaccination schedule.

Is the hepatitis A vaccine on the NHS?

The hepatitis A vaccine is available on the NHS for individuals at high risk of infection. This includes people travelling to countries where hepatitis A is common, people with certain medical conditions, and individuals in certain occupations.
For travel purposes, it’s advised to consult with a healthcare provider about your eligibility for an NHS-funded vaccine.

How does hep a interact with other vaccines?

The hepatitis A vaccine does not interact with other vaccines and can be given at the same time or any time before or after other vaccines including:

  • Typhoid-injection or oral vaccine
  • Hepatitis B vaccine
  • Diphtheria, Tetanus and Polio vaccine
  • Rabies vaccine
  • Yellow fever
  • Oral Cholera vaccine
  • Japanese encephalitis vaccine
  • MMR combined vaccine and other vaccines in the routine UK immunisation schedule

Who is not able to have the hepatitis A vaccine?

The hepatitis A vaccine is not recommended for individuals with a known severe allergy to any component of the vaccine or those who have had a severe allergic reaction to a previous dose of the vaccine.
Additionally, those with acute, severe illnesses are advised to delay vaccination until recovery. Pregnant women should consult with their healthcare provider, as the vaccine is usually given only if there’s a high risk of hepatitis A infection.

What does the Hepatitis A vaccine contain?

The common Hepatitis A vaccines contain:

  • 2-phenoxyethanol
  • Formaldehyde
  • Medium 199 Hanks -a complex mixture of amino acids (including phenylalanine), mineral salts, vitamins and other components.
  • Water for injections
  • Hydrochloric acid and sodium hydroxide for pH adjustment
  • Traces amounts of neomycin (an antibiotic) and formaldehyde (a preservative) may be found in the vaccines.

None of the hepatitis A vaccines contain:

  • Egg
  • Latex
  • Gelatin
  • Thiomersal (mercury)

Can I still get the Hepatitis A vaccine if I am travelling in less than 2 weeks.

The hepatitis A vaccine can be given any time before travel up to the day of departure. This is because the incubation periods of the infection is 14-28 days and you would have immunity by the time the infection develops.

Can I get my second dose of hepatitis A vaccine if I had my first dose many years ago?

Studies have shown that the immune boosting effects of the Hepatitis A vaccine can occur even when the second dose is given several years after the first dose. Therefore, you do not need to start the course again and can receive your second dose several years later if required for travel.

Additionally, the manufacturer’s advise that for:

  • Havrix Monodose vaccine-the second dose can be given yup to 5 years after the 1st dose.
  • Avaxim-the second dose can be given 3 years after the 1st dose.

What if I am unwell on the day of the vaccination, should I still attend?

If you do not have a high fever, then the vaccine can be given. If you have a fever, then it is best to postpone the vaccination until you have recovered. The decision to vaccinate in minor illnesses would depend on the assessment by the clinician on the day. 

Can the hepatitis A vaccine be given to babies?

The vaccine can only be given to infants over 1 year of age. Babies under 1 year cannot have the vaccine. If you are travelling with an infant under 1 year of age, discuss with your CityDoc clinician who will advise you on measures to prevent the disease.

Can Hepatitis A be given to people with chronic liver disease?

The vaccine can be given to anyone with chronic or severe disease of the liver. Indeed, hepatitis A is more likely to cause severe illness in those who have pre-existing liver disease and thus, vaccination is recommended. The vaccine is inactivated and cannot cause liver disease.

Written by Travel Health and Vaccination Lead Derek Evans

Edited on 03-11-2023
Next edit on 26-11-2024

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Whether you are going on a honeymoon, trekking or going on a last minute business trip, we can provide you with a comprehensive travel clinic service. Our specialist nurses and pharmacists offer vaccinations for travel to any country in the world, as well as destination specific health advice tailored to your itineraries. Click here for a full list of vaccinations we offer. Please note: Parents or legal guardians will need to directly accompany any child who is being vaccinated and bring along a photo ID for themselves.

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Our pre-travel consultations are with experienced travel health specialists and pharmacists who will assess the impact of any pre-existing medical conditions along with your vaccine requirements. They will discuss in detail countries at risk, precautions you can take to avoid exposure and how to travel safely. We also highly recommend visiting the government websites which has the latest travel news and advice for every destination.

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