Do I Need To Pay For Hepatitis A Immunisation
Vaccines covered by the NIP are free for people who are eligible. See the NIP Schedule to find out which vaccines you or your family are eligible to receive.
Eligible people get the vaccine for free, but your health care provider may charge a consultation fee for the visit. You can check this when you make your appointment.
If you are not eligible for free vaccine, you may need to pay for it. The cost depends on the type of vaccine, the formula and where you buy it from. Your immunisation provider can give you more information.
Types Of Hepatitis A Vaccine
There are 3 main types of hepatitis A vaccination:
- a vaccine for hepatitis A only
- a combined vaccine for hepatitis A and hepatitis B
- a combined vaccine for hepatitis A and typhoid fever
Talk to your GP about which vaccine is most suitable for you. All 3 types are usually available for free on the NHS.
Plan your vaccinations in advance if you’re travelling abroad. They should ideally be started at least 2 or 3 weeks before you leave, although some can be given up to the day of your departure if necessary.
Extra doses of the vaccine are often recommended after 6 to 12 months if you need long-term protection.
You can find more information about the various hepatitis A vaccines on the NHS Fit for Travel website.
What You Need To Know
1. What is hepatitis A?
Hepatitis A is a serious liver disease caused by the hepatitis A virus . HAV is found in the stool of persons with hepatitis A. It is usually spread by close personal contact and sometimes by eating food or drinking water containing HAV.
Hepatitis A can cause:
- severe stomach pains and diarrhea
People with hepatitis A often have to be hospitalized .
Sometimes, people die as a result of hepatitis A .
A person who has hepatitis A can easily pass the disease to others within the same household.
Hepatitis A vaccine can prevent hepatitis A.
2. Who should get hepatitis A vaccine and when?
Some people should be routinely vaccinated with hepatitis A vaccine:
- All children 1 year of age.
- Persons 1 year of age and older traveling to or working in countries with high or intermediate prevalence of hepatitis A, such as those located in Central or South America, Mexico, Asia , Africa, and eastern Europe. For more information see www.cdc.gov/travel.
- Children and adolescents through 18 years of age who live in states or communities where routine vaccination has been implemented because of high disease incidence.
- Men who have sex with men.
- Persons who use street drugs.
- Persons with chronic liver disease.
- Persons who are treated with clotting factor concentrates.
- Persons who work with HAV-infected primates or who work with HAV in research laboratories.
Other people might get hepatitis A vaccine in special situations:
5. How can I learn more?
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Aboriginal And Torres Strait Islander People
Aboriginal and Torres Strait Islander children living in these states and territories are recommended to receive 2 doses of monovalent hepatitis A vaccine:
- the Northern Territory
This is due to the increased risk for hepatitis A in this population.1 See Epidemiology.
These children should receive:
- 1st dose at 18 months of age
- 2nd dose at 4 years of age
Aboriginal and Torres Strait Islander children < 10 years of age who have not received hepatitis A vaccine at the recommended schedule points may need extra doses of vaccine and/or an alternative schedule.
See Catch-up vaccination for more details, including minimum intervals between doses.
Hepatitis A vaccination is recommended for people with chronic liver disease of any aetiology, if they are not immune to hepatitis A.2,3 This includes:
- people with chronic liver disease
- people who have received a liver solid organ transplant
- people with chronic hepatitis B
- people with chronic hepatitis C
2 doses are required, with a recommended minimum interval between doses of 6 months.
People with chronic liver disease should receive the vaccine as early in the course of the disease as possible. Immune responses to vaccination in these people can vary for example:
- people with chronic liver disease of mild to moderate severity usually mount a good immune response
- people with end-stage liver disease do not respond as well
- liver transplant recipients may not respond at all 4,5
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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Guidance On Reporting Adverse Events Following Immunization
Vaccine providers are asked to report, through local public health officials, any serious or unexpected adverse event temporally related to vaccination. An unexpected AEFI is an event that is not listed in available product information but may be due to the immunization, or a change in the frequency of a known AEFI.
Refer to Reporting Adverse Events Following Immunization in Canada and Vaccine Safety and Pharmacovigilance in Part 2 for additional information about AEFI reporting.
What Are The Possible Side Effects Of Hepatitis A Immunisation
All medicines and vaccines can have side effects. Sometimes they are serious, most of the time theyre not.
For most people, the chance of having a serious side effect from a vaccine is much lower than the chance of serious harm if you caught the disease.
Talk to your doctor about possible side effects of hepatitis A vaccines, or if you or your child have possible side effects that worry you.
Common side effects of hepatitis A vaccines include:
- pain where the needle went in.
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Safety Of Hepatitis Vaccines
Hepatitis vaccines have been given to millions of people all across the world without any evidence of serious side effects. “They’re very safe, and they’re extremely effective,” says Poland.
If you are not sure whether you should have hepatitis vaccines, talk with your doctor about your specific concerns.
Hepatitis A And B Vaccine Side Effects
Get emergency medical help if you have any of these signs of an allergic reaction:hives difficulty breathing swelling of your face, lips, tongue, or throat.
Keep track of any and all side effects you have after receiving this vaccine. When you receive a booster dose, you will need to tell the doctor if the previous shot caused any side effects.
You should not receive a booster vaccine if you had a life-threatening allergic reaction after the first shot.
Becoming infected with hepatitis is much more dangerous to your health than receiving this vaccine. However, like any medicine, this vaccine can cause side effects but the risk of serious side effects is extremely low.
You may feel faint after receiving this vaccine. Some people have had seizure like reactions after receiving this vaccine. Your doctor may want you to remain under observation during the first 15 minutes after the injection.
numbness, tingling, or burning pain
red or blistering skin rash with burning or tingly feeling
easy bruising or bleeding or
unexplained muscle pain, tenderness, or weakness.
Common side effects include:
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report vaccine side effects to the US Department of Health and Human Services at 1-800-822-7967.
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Who Should Be Immunised Against Hepatitis A
Travellers to countries outside Western Europe, North America and Australasia should consider being immunised. The highest-risk areas include the Indian subcontinent , Africa, parts of the Far East , South and Central America and the Middle East. Vaccination is generally recommended for anyone over the age of 1 year. Your doctor or practice nurse can advise if you should be immunised against hepatitis A for your travel destination.
You can find out if immunisation against hepatitis A is recommended for any countries you are planning to visit from the NHS website Fitfortravel.
Close contacts of someone with hepatitis A. Occasional outbreaks of hepatitis A occur in the UK within families or in institutions. Close contacts of someone found to have hepatitis A infection may be offered vaccination. This only happens rarely. The most important measure for anybody with hepatitis A is good personal hygiene. In particular, washing hands after going to the toilet or before eating.
People with chronic liver disease. If you have a persistent liver disease it is suggested that you have the hepatitis A vaccine. Hepatitis A infection is not more common in those with chronic liver disease but, if infection does occur, it can cause a more serious illness.
People exposed to hepatitis A at work. For example, laboratory workers who are exposed to hepatitis A during their work and sewage workers are advised to be immunised against hepatitis A.
Where Does Hepatitis A Occur
Hepatitis A is a very common illness throughout the world. Even developed countries like Canada, the United States or Australia can have outbreaks. But, some regions carry a higher risk of infection.
The vaccine is recommended for travel to almost every region of the world. Some of the most popular destinations where hepatitis A vaccination would be recommended include:
To find out if hepatitis A vaccination is recommended for your trip, see our destination advice portal.
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Who Should Get Hepatitis Vaccinations
Since the vaccines were first developed, the hepatitis A and B vaccines have become part of the regular childhood immunization schedule. They are not considered a routine adult immunization.
“When we’re talking about adults, I would say yes, get the vaccine if they fit into one of these risk factors” says Poland. “If they don’t fit into the risk factors, their risk is so low that there’s no compelling reason to do it.”
People at risk for hepatitis A include:
- Anyone traveling to or working in areas where hepatitis A is more widespread.
- People whose work puts them in potential contact with hepatitis A, such as those who work with the hepatitis A virus in research labs
- People who are treated with clotting-factor concentrates
- People who have chronic liver disease
- People who use recreational drugs, injected or not
- Men who have sex with men
People at risk for hepatitis B include:
- Anyone traveling to or working in areas where hepatitis B is more widespread.
- Health care workers and other people whose job exposes them to human blood
- People with HIV infection, end-stage kidney disease, or chronic liver disease
- People who live with someone with hepatitis B
- People who inject street drugs
- Sexually active people who have had more than one partner
- Anyone who has had an STD
- Men who have sex with men
- Sex partners of people with hepatitis B
Interchangeability Of Hepatitis A Vaccines
Vaccine manufacturers use slightly different methods to produce the vaccines and quantify the hepatitis A virusantigen content. All monovalent hepatitis A vaccines that are given as a 2-dose course are interchangeable. See Table. Recommended doses and schedules for monovalent hepatitis A vaccines.
Schedules that mix combination hepatitis A/hepatitis B vaccines with monovalent vaccines are not routinely recommended.
An adult dose of Twinrix 720/20 contains half the hepatitis A antigen content of an adult dose of Havrix adult vaccine. These vaccines are therefore not interchangeable.
The only absolute contraindications to hepatitis A vaccines are:
- anaphylaxis after a previous dose of any hepatitis A vaccine
- anaphylaxis after any component of a hepatitis A vaccine
Combination hepatitis A/hepatitis B vaccines are contraindicated in people with a history of anaphylaxis to yeast.
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Vaccines For Hepatitis A And B
Our immune system battles foreign invaders every day, such as when we get a cold virus. When this happens, we develop immunity to that specific virus. This means that our body will fight off the virus if it is ever exposed to it again.
The same protection happens with vaccines. However, the benefit of a vaccination is that you don’t have to go through being sick to enable your body to fight off disease.
Gregory Poland, MD, director of the Mayo Clinic’s Vaccine Research Group, explains that hepatitis vaccinations contain a small amount of the inactive virus. When you get a dose of the vaccine, he says, your immune cells respond by developing immunity against the virus. This immunity lasts over a long period of time.
“So if I get these two doses of hepatitis A vaccine, and then I get exposed 30 years from now, my body will remember that immunity to the vaccine and rapidly start producing antibodies again,” says Poland.
Due to the way hepatitis vaccinations are developed, it is impossible to contract the virus from the vaccine itself, according to Poland.
The hepatitis A vaccine is usually given in two shots and the hepatitis B vaccine is administered as a series of three shots. The most common side effects are redness, pain, and tenderness where the shots are given.
To get long-term protection from these viruses, it’s important to receive all the shots as scheduled. However, if you received one shot and never went back for the others, it’s not too late to catch up.
How Does Hepatitis A Spread
Contaminated food or water is the most common source of hepatitis A infection. Contamination can happen at any point in the food growing, processing or cooking process. Travelers are at an increased risk. Take extra precautions in developing countries with poor sanitary conditions.
It is possible for the disease to spread through close contact with an infected person. This includes sex or caring for an infected person.
Vaccination is the best form of protection.
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Are There Any Adults Who Should Not Get The Vaccine
Do not get the hepatitis vaccine if you:
- Have ever had a severe allergic reaction to a hepatitis A vaccine or to any vaccine component hepatitis A vaccines contain alum and some contain 2-phenoxyethanol.
- Are ill, unless it is a mild illness
- Are pregnant, unless you are at greater risk for contracting hepatitis A
How Is This Vaccine Given
This vaccine is given as an injection into a muscle. You will receive this injection in a doctor’s office or other clinic setting.
The hepatitis A and B vaccine is given in a series of 3 shots. The booster shots are given 1 month and 6 months after the first shot.
If you have a high risk of hepatitis infection, you may be given 3 shots within 30 days, and a fourth shot 12 months after the first.
Your individual booster schedule may be different from these guidelines. Follow your doctor’s instructions or the schedule recommended by the health department of the state you live in.
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Who Should Get The Hepatitis A Vaccine
The hepatitis A vaccine is given to those 6 months of age and older as a series of 2 doses. The second dose is given at least 6 months after the first.
Over the last 15 years there have been many outbreaks of hepatitis A in Aboriginal communities in B.C., and so the hepatitis A vaccine has been offered to Aboriginal children living both on-reserve and off-reserve since January 1, 2012.
The hepatitis A vaccine is provided free to people at high risk of infection, including:
- those who have hemophilia or receive repeated infusions of blood or blood products
- those who inject illegal drugs or share drug snorting, smoking, or injecting equipment
- males who have sex with other males
- those with HIV, hepatitis B or hepatitis C infection, or chronic liver disease
- those who have had a stem cell transplant
- those who will have or have had a liver transplant
- inmates of a correctional facility
- those who are in close contact with persons infected by the hepatitis A virus such as people living in the same house, sexual partners, close friends, and children in the same daycare
- those who have eaten food prepared by a food handler with hepatitis A infection and
- Aboriginal children and adolescents aged 6 months to 18 years. Babies get their first dose at 6 months of age and the second dose at 18 months. Older children need 2 doses of vaccine with at least 6 months between doses.
It is important to keep a record of all immunizations received.
What Happens If I Miss A Dose
Contact your doctor if you miss a booster dose or if you get behind schedule. The next dose should be given as soon as possible. There is no need to start over.
Be sure you receive all recommended doses of this vaccine. You may not be fully protected against disease if you do not receive the full series.
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For Those Needing The First Dose Of The Hepatitis A Vaccine
If you are 19 and older and have health insurance:
- Your healthcare provider
- University of Louisville Pharmacy, 550 S. Jackson St.
- 7:30am – 7:00pm Monday – Thursday
- 7:30am – 5:00pm Friday
If you are 19 and older and do NOT have health insurance:FOR THOSE ON MEDICARE: Medicare Part D should cover the cost of your Hepatitis A vaccination. Click HERE for more information you can share with your healthcare provider or pharmacy. Call Medicare or your plan provider first to understand any restrictions or cost that may be involved.
For hepatitis A vaccines for children contact:
- Your healthcare provider