Hepatitis A Vaccine:Dose,Mode,Schedule,Side Effects,Contraindications

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HEPATITIS-A VACCINE

Q. What is Hepatitis A vaccine?
A. Hepatitis A vaccine protects against Hepatitis A - a virus that leads to jaundice and infection of the liver.

Q. Which Hepatitis -A vaccines are available?
A. 5 vaccines are available. Biovac A (Internationally - Zhepu), Havrix, Avaxim, Vaqta and Epaxal. Only the first 3 brands are available in India.

Q. What is the dose, mode and schedule of administration?
A. The dose and schedule differ with the 3 vaccines.
BIOVAC A is single dose to be administered subcutaneously in a child above 1 year of age. Havrix for pediatric use - 2 doses of 720 EU at 1 year and 1 ½ years of age intramuscularly. Vaqta for pediatric use is given as 2 doses of 1 year and 1 ½ years of age intramuscularly.

Q. What are the side effects of hepatitis - A vaccine?
A. The side effects are very rare and mild. Local side effects seen include redness, swelling in < 5% and pain at injection site seen in <20% cases. Systemic side effects like mild fever, headache, and malaise can be seen in 10 - 20% of cases.

Q. What are the contraindications?
A. Killed Hepatitis - A vaccine also contains aluminum hydroxide and phenoxyethanol. Hence patients known to have hypersensitivity to these agents should not be given the vaccine. It is also contraindicated during pregnancy. The live vaccine does not contain aluminium hydroxide.

Q. Who should be vaccinated?
A. At present it is recommended for the following high-risk group of patients.

Though Hepatitis-A is a self limiting disease, there is no effective treatment. In addition there is occasional mortality due to fulminant hepatitis especially in adolescent and adults.Thus primary immunization may be recommended for pre-exposure prophylaxis in individuals who are at increased risk of the infection such as -
- Foreign traveller : Those staying in low endemic areas for Hepatitis A do not develop natural immunity till adulthood. Such persons are at risk of developing Hepatitis A when they visit an area with high endemicity. If such a person is going to stay for <3 months, Hepatitis A immunoglobulin can be enough to prevent hepatitis-A. If the stay is going to be prolonged it is better to give the vaccine.
- Patients with chronic liver disease who may be at increased risk of fulminant hepatitis A.
- During epidemics: Whenever there is an outbreak of Hepatitis A in a community.
- IV drug abusers.
- Those who have occupation hazards like staff working in laboratories, food handlers, health personnel, zoo keepers, veterinarians, emergency relief workers and members of armed forces.
- Those who work in day-care centers or schools or institutionalized children etc.
Children from a higher socio-economic group who may not have had natural infection may be given the Hepatitis A vaccine.

Q. Can hepatitis-A vaccine be given along with other vaccines?
A. Yes, hepatitis-A vaccine can be given along with any other vaccine provided one uses separate syringes and separate sites for different vaccines.

First created on 02-12-2003
Last updated on 01-03-2006

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