How Long Is The Hepatitis A Vaccine Good For

Is Hep B Booster Necessary

13, 2005 The hepatitis B vaccine lasts for more than 10 years, so a booster vaccine may not be necessary, Italian researchers report. Booster doses of vaccine do not seem necessary to ensure long-term protection, write Alessandro Zanetti, PhD, and colleagues in The Lancet.

Should I Get The Hepatitis A Vaccine

Hepatitis A

Hepatitis A vaccination is recommended for:

• Travelers to countries that have high rates of hepatitis A
• Family members or caregivers of a recent adoptee from countries where hepatitis A is common
• Men who have sex with men
• People who use injection and non-injection drugs
• People with chronic liver diseases, such as hepatitis B or hepatitis C
• People who are teated with clotting-factor concentrates
• People who work with hepatitis A infected animals or in a hepatitis A research laboratory
• People who are experiencing homelessness
• People age 40 and older at increased risk for hepatitis A infection, or who are at increased risk for severe disease from hepatitis A infection who also have other risk factors
• People age 19 or older at increased risk for hepatitis A infection, or who are at increased risk for severe disease from hepatitis A infection who also have other risk factors

Health care providers recommend that all children receive a hepatitis A vaccination at around 1 year of age, but many adults have never received the vaccine because it only became available in 1995.

Health care personnel and patients with the following conditions should discuss the hepatitis A vaccination with their health care provider: pregnancy, immunocompromising conditions, HIV infection, heart disease, chronic lung disease, chronic alcoholism, asplenia, kidney failure.

You should NOT get the hepatitis A vaccination or you should wait, if you:

Hepatitis A And B Vaccination

Effective and well-tolerated hepatitis A and B vaccines are available either as monovalent formulations or in various combinations. Although the benefits of a full primary vaccination course are clearprotection against potentially life-threatening diseasesthe requirement for a booster varies in different countries. Recommendations for the administration of hepatitis boosters in the United States, the United Kingdom, and Germany illustrate this. In the United States, a hepatitis B booster is not recommended for children and adults with a normal immune status , whereas in the United Kingdom, administration of a single booster dose 5 years after completion of the primary course is deemed necessary . In Germany, for example, Empfehlungen der Ständigen Impfkommission recommendations published in July 2004 state that immune response should be checked for persons who are immunodeficient and suggest the same for persons aged > 40 years. For persons with antihepatitis B surface antigen titers of < 100 mIU/mL, 1 extra dose is recommended, followed by an additional antibody test. In vaccinees with anti-HBs titers of > 100 mIU/mL, a booster is recommended after 10 years when the potential for risk continues . The World Health Organization has recognized that almost all children are protected against hepatitis B after vaccination, without a requirement for boosters, and that the protection is most likely lifelong .

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Twinrix: The Vaccine For Hepatitis A And B

Both hepatitis A and B are identified by obtaining a blood sample, which you submit to a laboratory test. This test decides whether you have antibodies in the blood unique to those viruses. If the result is positive, you have been subjected to either hepatitis A or B.

To check whether anyone has hepatitis B, the test will see whether the individual has certain hepatitis B antigen levels.

Take Care When Eating And Drinking

You should avoid eating and drinking the following when travelling to high-risk countries:

• Raw or inadequately cooked shellfish.
• Raw salads and vegetables that may have been washed in dirty water.
• Other foods that may have been grown close to the ground such as strawberries.
• Untreated drinking water, including ice cubes made from untreated water.
• Unpasteurised milk, cheese, ice cream and other dairy products.

Also be careful when buying food from street traders. Make sure that food has been recently prepared and that it is served hot and on clean serving plates. Food that has been left out at room temperature or food that may have been exposed to flies could also pose a risk.

Note: if you have had hepatitis A infection, you will be immune to further infection. This means that you can’t catch the infection again.

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Who Should Receive Twinrix

According to Canadian medical advice, the vaccine is required for all those seeking to minimize their hepatitis A and B infection risk. Twinrix is used for vaccinating adults, teenagers, youngsters and babies above one year of age.

In specific, vaccination against hepatitis A is suggested for:

• Travellers to countries or areas with a risk for hepatitis A
• The Canadian armed forces, emergency organization, or any other organization likely to be sent at short notice to high-risk areas for hepatitis A
• Zoo workers, veterinarians, and researchers
• People diagnosed with liver disease
• Hemophiliacs

Hepatitis B vaccination is prescribed for those who:

• Travellers to countries or areas with a risk for hepatitis B
• Nurses, including medical students
• People in contact with someone with hepatitis B
• People who use medication through injections
• Hemophiliacs
• Immigrants and students coming to Canada

What Are The Differences Between Hepatitis A B And C

Hepatitis A, B and C are liver infections caused by three separate viruses. Each can cause similar symptoms, but they have different modes of transmission and can affect the liver differently. Hepatitis A is normally a shorter-term infection, and does not become chronic or life-long. Hepatitis B and C can potentially begin as short-term, acute infections. But in some, the virus stays in their body, resulting in chronic disease and long-term liver issues.

There is a vaccine to prevent Hepatitis A and B. But there is currently no vaccine for Hepatitis C.

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People Whose Lifestyle Increases Their Risk Of Acquiring Hepatitis A

Serological testing for hepatitis A immunity is not routinely recommended, but may be appropriate for some people

Serological testing for immunity to hepatitis A is not routinely recommended before receiving hepatitis A vaccine.

It is also inappropriate to test people who cannot remember whether they have ever had a hepatitis A vaccine. If a person is recommended for vaccination and has no records of previous vaccination, they should receive a vaccine.

However, certain groups of people should be screened for natural immunity to hepatitis A to avoid unnecessary vaccination:

• people who were born before 1950
• people who spent their early childhood in hepatitis Aendemic areas
• people with an unexplained previous episode of hepatitis or jaundice

People with unexplained jaundice should also be tested for other causes of hepatitis, including hepatitis B.

These people may need to be tested for total hepatitis A antibodies or IgG antibodies against hepatitis A virus. A positive test indicates immunity to hepatitis A. People who are immune do not need hepatitis A vaccination.

To better interpret serological testing results, discuss them with the laboratory that performed the test. Ensure that the laboratory receives the relevant clinical information.

See also Vaccine information and Variations from product information for more details.

Are There Any Possible Complications

Serious illness is rare with hepatitis A infection. The illness can be unpleasant and make you feel quite ill however, most people make a full recovery. In a small number of cases, the infection can cause severe liver inflammation leading to liver failure. This is more common in older people who develop this infection. An extremely small number of people die from severe hepatitis A infection. A liver transplant can be life-saving if liver failure develops.

Somewhere between 1 to 2 in 10 people who get hepatitis A infection will seem to recover but will then have a return of their symptoms between about one and three months after their original illness. This is because the infection hadn’t cleared completely. This relapse will have similar symptoms to the initial illness. Some people can have a relapse of their symptoms more than once.

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Immunizing Agents Available For Use In Canada

Hepatitis A-containing vaccines

• AVAXIM® and AVAXIM®-Pediatric , Sanofi Pasteur SA , Sanofi Pasteur Ltd.
• HAVRIX®1440 and HAVRIX®720 Junior , GlaxoSmithKline Inc.
• TWINRIX® and TWINRIX®Junior , GlaxoSmithKline Inc. Refer to Hepatitis B Vaccine in Part 4 for additional information about HAHB vaccine.
• VAQTA® , Merck Canada Inc.
• ViVAXIM® , Sanofi Pasteur Ltd.

Human immunoglobulin

• GamaSTAN® , Grifols Therapeutics LLC.

Standard human immunoglobulin is a sterile, concentrated solution for intramuscular injection containing 15% to 18% immunoglobulin. It is obtained from pooled human plasma from screened donors and contains mainly IgG with small amounts of IgA and IgM. For complete prescribing information, consult the product leaflet or information contained within the product monograph available through Health Canada’s Drug product database.

Refer to Contents in Immunizing Agents Available for Use in Canada in Part 1 for lists of vaccines and passive immunizing agents available for use in Canada and their contents.

Side Effects Of Immunisation Against Hepatitis A

Immunisations against hepatitis A are effective and safe. All medications can have side effects.

For most people, the chance of a serious side effect from a vaccine is much lower than the chance of serious harm if you catch the disease.

Common side effects from the hepatitis A vaccine include:

• localised pain, redness and swelling at the injection site
• low-grade temperature
• headache.

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Reducing The Risk Of Hepatitis A

Protecting yourself from hepatitis A

The most important action you can take to protect yourself against hepatitis A is to get vaccinated.

Practising strict personal hygiene is also essential to reducing the risk of hepatitis A. Steps you can take include:

• Wash your hands with soap and hot running water before handling food, after going to the toilet and after handling used condoms or having contact with nappies or the anal area of another person. Use a clean towel to dry your hands.
• Use barrier protection when engaging in oral-anal sex and avoid sex with someone who is infected with the hepatitis A virus.
• Vaccination may prevent illness if given within 2 weeks of contact with an infectious person.
• Clean bathrooms and toilets often, paying attention to toilet seats, handles, taps and nappy change tables.
• Boil your drinking water if it comes from an untreated source, such as a river.
• If you are travelling overseas, particularly to countries where hepatitis A is widespread, take special care to avoid hepatitis A. Before travelling, talk to your doctor about immunisation for protection.

Protecting others from hepatitis A

If you have hepatitis:

• Wash eating utensils in soapy water, and machine wash linen and towels.

Household contacts and sexual partners of an infectious person may need to be immunised.

All people who have hepatitis A should check with their doctor before returning to work or school.

Protecting yourself from hepatitis A when overseas

Who Should Have The Hepatitis A Vaccine

People usually advised to have the hepatitis A vaccine include:

• close contacts of someone with hepatitis A
• people planning to travel to or live in parts of the world where hepatitis A is widespread, particularly if sanitation and food hygiene are expected to be poor
• people with any type of long-term liver disease
• men who have sex with other men
• people who inject illegal drugs
• people who may be exposed to hepatitis A through their job this includes sewage workers, people who work for organisations where levels of personal hygiene may be poor, such as a homeless shelter, and people working with monkeys, apes and gorillas

Contact your GP surgery if you think you should have the hepatitis A vaccine or you’re not sure whether you need it.

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The Hep A Vaccine And How Its Administered

The hep A vaccine is an inactivated vaccine shot which contains dead hepatitis A virus. And in light of the recent anti-vaccination lobby, it should be stated that this vaccine is perfectly safe. Since its first introduction in 1995, millions of people have been inoculated without any serious complications.

Some minor side effects may appear, including soreness in the injection site, mild fever, and fatigue. These symptoms disappear on their own after a few days and allergic reactions to the vaccine are very rare. Whats more, this vaccine doesnt pose any threat to pregnant women or the fetus.

As for the type of hep A vaccine in the US, there are two licensed single-antigen vaccines and a combination vaccine called TWINRIX. For the shots, you can get any combination of the above.

It doesnt interfere with other vaccines so it can be administered at the same time as other vaccines like the ones for diphtheria, polio, cholera, yellow fever, etc. The injection area is, of course, different.

As mentioned, two doses of the vaccine are required for 20-plus-years of protection. In general, at least 6 months should go by between the shots. Adults receive the vaccine in the upper arm muscle and children in the thigh muscle.

Managing Injection Site Discomfort

Many vaccine injections may result in soreness, redness, itching, swelling or burning at the injection site for one to 2 days. Paracetamol might be required to ease the discomfort. Sometimes a small, hard lump at the injection site may persist for some weeks or months. This should not be of concern and requires no treatment.

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Symptoms Of Hepatitis A

You can become ill any time between 2 and 4 weeks after coming into contact with the hepatitis A virus.

The average incubation period for the virus is 28 days.

Many infected people, particularly children less than 5 years old, show few or no symptoms.

For older children and adults, the symptoms of hepatitis A include:

• yellow skin and eyes .

Symptoms may last for several weeks. Most people fully recover from hepatitis A infection.

A single infection of hepatitis A leads to lifelong immunity. Prior infection with hepatitis B or hepatitis C does not offer immunity for hepatitis A.

Immunisation Against Hepatitis A

Immunisation is the best protection against hepatitis A infection and is recommended for people in high-risk groups, and for unvaccinated people who have been in close contact with someone who has hepatitis A.

Immunisation against hepatitis A includes a course of injections over a 6 to 12-month period. Healthy people 12 months of age and over receive 2 doses of hepatitis A vaccine, or 3 doses if the hepatitis A and hepatitis B vaccines are given as a combination.

You can complete any missed vaccine doses, even if the recommended time frame has passed. You do not need to start the vaccine course again.

If you are in close contact with someone who has hepatitis A be sure to have the hepatitis A vaccine if you have not already completed a vaccine course.

Babies under 12 months of age and people who have a weakened immune system who are also in close contact with a person with hepatitis A can have an injection of normal human immunoglobulin instead of the hepatitis A vaccine.

Protection against hepatitis A is available free of charge under the National Immunisation Program Schedule for Aboriginal and Torres Strait Islander children who live in high-risk areas .

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Who Should Get Vaccinated

The common practice in most of the developed world is to vaccinate all children at the age of one. And it is highly recommended to get vaccinated or revaccinated if you are at a greater risk of contracting the infection. This goes double for people who might be prone to hep A complications.

Those who are at greater risks can be divided into several categories. Frequent travelers to counties with high incidences of hepatitis A. It may not be enough to just maintain good hygiene, mind your food, and stay in high-end hotels.

People who work with primates might also be at greater risks of contracting hep A infection. The same goes for liver disease patients, those with clotting disorders, and homosexual/bisexual men.

Who Should Get The Hepatitis A Vaccine

The CDC recommends that all children between ages 12 months and 23 months get this vaccine as well as for any infant aged 6 to 11 months who is traveling internationally.

The following people are also at risk for the disease and should be vaccinated:

• Children and teens through age 18 who live in states or communities that have made this vaccination routine because of a high rate of disease
• Men who have sex with men
• Anyone who uses illegal drugs
• People with chronic liver disease
• Anyone treated with blood clotting drugs, such as people with hemophilia
• People who work with HAV-infected primates or in HAV research laboratories.
• Travelers to countries where hepatitis A is common. A good source to check is the CDCâs travelersâ health website, which you can search by the country youâre going to.
• People adopting or close to a child adopted from a country where hepatitis A is common

You should not get the vaccine if you’re allergic to any ingredients in it or if you had a severe allergic reaction to an earlier dose of it. Tell your doctor or pharmacist about any allergies you have.

If you’re pregnant, let your doctor know. The safety of this vaccine for pregnant women is unknown, although the risk is considered to be very low.

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