Hepatitis A vaccine - Types, Schedule of Administration, Side Effects - Immunization
Last Updated : 2/1/2016
Sayenna Uduman
Hepatitis A Vaccines (HepA vaccines)
Commercially available HepA vaccines are Havrix (GlaxoSmithKline, USA), Vaqta (Merck & Co Inc., USA ) and Avaxim (Sanofi Pasteur; France, Canada). The vaccines are prepared from cell culture-adapted HAV, which is propagated in human fibroblasts, purified from cell lysates, formalin inactivated, and adsorbed to an aluminum hydroxide adjuvant. The pediatric doses contain half the amount of viral antigen and aluminum. Inactivated whole-virus vaccines require a booster at least 6 months after the initial dose.

Routine vaccination:
• The IAP and the Advisory Committee on Immunization Practices (ACIP) USA , recommends routine vaccination against HAV of all children, starting at 12 to 23 months of age.
• Initiate the 2-dose inactivated HepA vaccine series at 12 months of age, with a booster dose 6 to 18 months later and catch-up for older children.
• The adult formulations are recommended for people 19 years and older.
• Completion of the immunization regimen with the same product is preferable; immunization with other inactivated product is acceptable.
• May be administered simultaneously with other childhood vaccines. Vaccines should be given in a separate syringe and at a separate injection site .
• Recommended doses and schedules for the Pediatrics & adults are given in the Table.1

Table: Recommended Doses and Schedules for Hepatitis A Virus (Hep A) Vaccines
Vaccine type Inactivated / Live attenuated Hep A vaccine dose Age Volume (ml) / route No. of doses Schedule
Inactivated Havrix (GSK)-CDC, US 720 ELU 12 months through 18 years 0.5/IM 2 Initial and 6–12 mo later
Inactivated Havrix (GSK)-CDC, US 1440 ELU 19 years or older 1.0/IM 2 Initial and 6–12 mo later
Inactivated Vaqta (Merck) CDC, US 25 U 12 months through 18 years 0.5/IM 2 Initial and 6–18 mo later
Inactivated Vaqta (Merck)-CDC, US 50 U 19 years or older 1.0/IM 2 Initial and 6–18 mo later
Inactivated Avaxim (Sanofi Pasteur; France, Canada) GBM strain – 80 antigen units (U) Children 0.5/IM 2 6mon apart
Inactivated Avaxim ( Fra, Canada) contains 160 antigen units Adult 0.5/IM 2 6mon apart
Live attenuated
Chinese vaccine HepA H2 strain (used in India )
LAV >2 years SC Single dose Limited published data , IMA , SAGE / WHO recommends
Combination Vaccines          
Twinrix [HepB (Engerix-B, 20 µg) and Hep A (Havrix, 720 ELU) ] 720 ELU 18 years or older 1.0/IM 3 or 4 Initial, 1 mo, and 6 mo later OR Initial, 7 days, and 21–30 days, followed by a dose at 12 mo
Viatim: ( typhoid / HepA- (sanofi Pasteur) 160 units Ag of inactivated HAV adolescent & adult use IM 1 Booster after 3 years


Contributor Information and Disclosures

Sayenna Uduman
Sayenna A Uduman MD, FAAP
Visiting Professor, Infection Control Committee & ID Division of the KIMS
Thiruvananthapuram, Kerala, India

First Created : 1/9/2001
Last Updated : 2/1/2016


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