• Hepatitis A Vaccine

    (Hep A Vaccine)

    What Is Hepatitis A?

    Hepatitis A is a viral infection that strikes the liver. The virus causes the liver to become swollen. Liver function is reduced. Waste that is normally eliminated by the liver builds up in the blood. Jaundice (yellowing of the skin and eyes) usually results.
    Hepatitis A is passed from person to person through contact with stool. You can get the virus from an infected child by changing a diaper or by having sexual contact with an infected person. Contaminated food and water can also spread the virus.
    The virus is very common in developing countries. It also occurs in the United States.
    Symptoms include:
    • Fever
    • Jaundice
    • Tiredness
    • Abdominal pain or soreness
    • Lack of appetite
    • Nausea
    • Headache
    • Chills
    If you have been in contact with the virus and have not been vaccinated, a shot of the vaccine or immune globulin (IG) can prevent you from getting sick. It can also prevent you from spreading the virus. Either shot should be given as soon as possible.
    If you do get sick, usually symptoms will resolve after rest, drinking plenty of fluids, and avoiding medicine that can damage the liver such as acetominophen and alcohol.
    At times, people with hepatitis A need to be hospitalized. Rarely, the infection can be fatal if the liver is damaged.

    What Is the Hepatitis A Vaccine?

    The vaccine contains a killed or inactivated form of the hepatitis A virus. It is given as an injection in the arm.
    A combined vaccine that protects against both hepatitis A and B is also available.

    Who Should Get Vaccinated and When?

    The vaccine is recommended for all children aged 12-23 months. The two doses of the series are given 6-18 months apart. Children who have not been vaccinated can receive the shot at their next doctor's visit.
    The following people should also get vaccinated:
    • Children aged 24 months or older who are at high risk and have not been previously vaccinated
    • People traveling to areas where hepatitis A is prevalent (The CDC's Traveler's Health website shows which areas have high rates hepatitis A.)
    • Men who have sex with men
    • Injection drug users
    • People who are at risk because of their job (eg, those working in research labs)
    • People with chronic liver disease
    • People treated with clotting factor concentrates
    • People who will have close contact with an adopted child from a medium- or high-risk area
    • People who want immunity to hepatitis A
    In general, people who are traveling should get the first dose at least one month before leaving the United States. Getting the vaccine anytime before traveling may also result in some protection.

    What Are the Risks Associated With the Hepatitis A Vaccine?

    There is a very small risk of severe allergic reaction, with symptoms such as:
    • Difficulty breathing
    • Skin rash
    • Rapid heartbeat
    • Dizziness
    • Wheezing
    Moderate side effects include:
    • Soreness at the site of injection
    • Headache
    • Loss of appetite
    • Fatigue

    Who Should Not Get Vaccinated?

    The following people should not get vaccinated:
    • Children under one year of age
    • Anyone who has already had hepatitis A
    • Anyone who has previously had a severe allergic reaction to the hepatitis A vaccine
    • Anyone who has previously had a severe allergic reaction to any component of the hepatitis A vaccine (including alum or 2-phenoxyethanol)
    • Anyone who very ill (If you are sick, wait until you have recovered.)

    What Other Ways Can Hepatitis A Be Prevented Besides Vaccination?

    • Wash your hands with soap and water, especially after using the restroom or changing a diaper.
    • IG given before and after exposure is another way of preventing and treating the virus.
    • Twinrix is another vaccine that protects against both hepatitis A and B.

    What Happens in the Event of an Outbreak?

    If a food-borne outbreak occurs, the source of the contaminated food will be identified and eliminated. In any hepatitis A outbreak, the affected community will get vaccinated to prevent the virus from spreading.

    WHERE CAN I GET MORE INFORMATION?

    Centers for Disease Control and Prevention http://www.cdc.gov/

    National Digestive Diseases Information Clearinghouse http://digestive.niddk.nih.gov

    References

    Baker CJ, Pickerling LK, Chilton L, et al; Advisory Committee on Immunization Practices. Recommended adult immunization schedule: United States, 2011. Ann Intern Med . 2011;154(3):168-173.

    Centers for Disease Control and Prevention. Recommended immunization schedules for persons aged 0-18 years —United States, 2011. MMWR 2011;60(5).

    Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines, 2010. MMWR 2010;59(No. RR-12):1-110.

    Hepatitis A. The American Academy of Family Physicians website. Available at: http://familydoctor.org/897.xml . Updated May 2010. Accessed November 30, 2012.

    Hepatitis A FAQs for the public. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/hepatitis/A/aFAQ.htm . Updated September 17, 2009. Accessed November 30, 2012.

    Hepatitis A: questions and answers. Immunization Action Coalition website. Available at: http://www.vaccineinformation.org/hepa/qandavax.asp . Updated October 2012. Accessed November 30, 2012.

    Hepatitis A: What you need to know. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-hep-a.pdf . Updated October 25, 2011. Accessed November 30, 2012.

    Recommended adult immunization schedule—United States, 2012. MMWR Morb Mortal Wkly Rep . 2012;6(4). Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/schedules/downloads/adult/mmwr-adult-schedule.pdf . Accessed November 30, 2012.

    Recommended immunization schedules for persons aged 0-6 years—United States, 2012. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/schedules/downloads/child/0-6yrs-schedule-pr.pdf . Published December 23, 2011. Accessed November 30, 2012.

    Viral hepatitis. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/hepatitis/index.htm . Updated October 2, 2012. Accessed November 30, 2012.

    1/31/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Centers for Disease Control and Prevention. Recommended immunization schedules for persons aged 0-18 years—United States, 2008. MMWR. 2008;57;Q1-Q4. Centers for Disease Control and Prevention, MMWR website. Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5701a8.htm . Updated January 10, 2008. Accessed January 28, 2008.

    9/25/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Updated recommendations from the Advisory Committee on Immunization Practices (ACIP) for use of hepatitis A vaccine in close contacts of newly arriving international adoptees. MMWR Morb Mortal Wkly Rep . 2009;58:1006.

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