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Antelope Valley Center
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HEPATITIS A VACCINE
Hepatitis A is a highly contagious infection causing inflammation of the liver, with the predominant mode of transmission being person to person via the fecal-oral route. Infection has been shown to spread 1) by contaminated water or food; 2) by infected food handlers; 3) after breakdown in usual sanitary conditions or after floods or natural disasters; 4) by ingestion of raw or undercooked shellfish (oysters, clams, mussels) from contaminated water; during travel to areas with poor hygienic conditions; 6) among institutionalized people; 7) in daycare centers where children have not been toilet trained; 8) by parenteral transmission, either blood transfusions or sharing needles with infected people.
Vaccination is now available for hepatitis A. Havrix, approved in February 1995, is an inactivated vaccine for hepatitis A, which induces active immunity within 15 days after a single dose.
Candidates for vaccination:
 | Travelers to countries where hepatitis A is a risk, primarily Mexico and parts of the Caribbean, Central and South America, Africa, Asia (except Japan), and parts of southern and southeastern Europe. The CDC recommends that these travelers be immunized against Hepatitis A. Even those in "resorts and middle and upper level hotels" are at risk. |
| Armed forces |
| People living in or relocating to areas of high endemicity |
| Certain ethnic and geographic populations, such as native peoples of Alaska and the Americas who experience cyclic hepatitis A endemics. Rates are higher in western states like California and Arizona, and in countries with >10% of the population classified as American Indian. |
| Other persons engaging in high risk sexual activity, such as in a community experiencing an outbreak of hepatitis A |
| Additionally, outbreaks of hepatitis A or exposure to hepatitis A virus have been described in a variety of populations in which Havrix may be useful: |
| Certain institutional workers (e.g., caretakers for the developmentally challenged) |
| Employees of child daycare centers |
| Laboratory workers who handle live hepatitis A virus |
| Handlers of primate animals that may be harboring hepatitis A virus |
Precautions:
| Febrile illness. Delay vaccination unless withholding the vaccine entails a greater risk. |
| Bleeding disorders. Administer with caution to people with a bleeding disorder as bleeding may occur with intramuscular use. |
| Pregnancy. Safety for use during pregnancy has not been established. |
| Lactation. It is not known whether the vaccine is excreted in breast milk. Exercise caution when administering to a nursing woman. |
| If other vaccines are given at the same time, give Havrix in a separate syringe at a separate site. |
Reactions:
| Injection site soreness which may include induration, redness, swelling. |
| Fatigue, low grade fever, malaise |
| Anorexia, nausea, vomiting, abdominal pain, diarrhea |
| Headache |
| Arthralgia |
See complete listing of adverse reactions in the Drug Facts and Comparisons.
Administration and Dosage:
Administer IM in deltoid region for adults. For optimal response it should not be given in the gluteal region.
Adults: one dose of 1.0cc (1440 EL.U.) IM
Booster: Repeat dose in 6 months to 1 year in order to assure the highest antibody titers.
Immune globulin may be given at the same time if necessary, however, the effectiveness may be diminished. Administration at the same time as Hepatitis B vaccine does not interfere with the immune response. When concomitant administration of other vaccines or immune globulin is required, they should be given at different injection sites.
Duration of Immunity: Length of protection has not been established.
Cost: $20.00 per injection.
Resources:
Drug Facts and Comparisons
Kern County Health Department
SmithKline Beecham
CSUB Student Health Service: 661/654-2394 2/06 ck