• Hepatitis A Vaccine

    What is hepatitis A?

    Hepatitis A is a serious liver disease caused by the hepatitis A virus (HAV). HAV is found in the stool of people with hepatitis A.
    It is usually spread by close personal contact and sometimes by eating food or drinking water containing HAV. A person who has hepatitis A can easily pass the disease to others within the same household.
    Hepatitis A can cause:
    • ''flu-like'' illness
    • jaundice (yellow skin or eyes, dark urine)
    • severe stomach pains and diarrhea (children)
    People with hepatitis A often have to be hospitalized (up to about 1 person in 5).
    Adults with hepatitis A are often too ill to work for up to a month.
    Sometimes, people die as a result of hepatitis A (about 3 to 6 deaths per 1,000 cases).
    Hepatitis A vaccine can prevent hepatitis A.

    Who should get hepatitis A vaccine and when?

    Some people should be routinely vaccinated with hepatitis A vaccine:
    • All children between their first and second birthdays (12 through 23 months of age).
    • Anyone 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 (except Japan), Africa, and eastern Europe. For more information see http://www.cdc.gov/travel .
    • Children and adolescents 2 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.
    • People who use street drugs.
    • People with chronic liver disease.
    • People who are treated with clotting factor concentrates.
    • People who work with HAV-infected primates or who work with HAV in research laboratories.
    • Members of households planning to adopt a child, or care for a newly arriving adopted child, from a country where hepatitis A is common.
    Other people might get hepatitis A vaccine in certain situations (ask your doctor for more details):
    • Unvaccinated children or adolescents in communities where outbreaks of hepatitis A are occurring.
    • Unvaccinated people who have been exposed to hepatitis A virus.
    • Anyone 1 year of age or older who wants protection from hepatitis A.
    Hepatitis A vaccine is not licensed for children younger than 1 year of age.
    For children, the first dose should be given at 12 through 23 months of age. Children who are not vaccinated by 2 years of age can be vaccinated at later visits.
    For others at risk, the hepatitis A vaccine series may be started whenever a person wishes to be protected or is at risk of infection.
    For travelers, it is best to start the vaccine series at least one month before traveling. (Some protection may still result if the vaccine is given on or closer to the travel date.)
    Some people who cannot get the vaccine before traveling, or for whom the vaccine might not be effective, can get a shot called immune globulin (IG). IG gives immediate, temporary protection.
    Two doses of the vaccine are needed for lasting protection. These doses should be given at least 6 months apart.
    Hepatitis A vaccine may be given at the same time as other vaccines.

    Who should not get hepatitis A vaccine or should wait?

    • Anyone who has ever had a severe (life threatening) allergic reaction to a previous dose of hepatitis A vaccine should not get another dose.
    • Anyone who has a severe (life threatening) allergy to any vaccine component should not get the vaccine. Tell your doctor if you have any severe allergies, including a severe allergy to latex.All hepatitis A vaccines contain alum, and some hepatitis A vaccines contain 2-phenoxyethanol.
    • Anyone who is moderately or severely ill at the time the shot is scheduled should probably wait until they recover. Ask your doctor. People with a mild illness can usually get the vaccine.
    • Tell your doctor if you are pregnant. Because hepatitis A vaccine is inactivated (killed), the risk to a pregnant woman or her unborn baby is believed to be very low. But your doctor can weigh any theoretical risk from the vaccine against the need for protection.

    What are the risks from hepatitis A vaccine?

    A vaccine, like any medicine, could possibly cause serious problems, such as severe allergic reactions. The risk of hepatitis A vaccine causing serious harm, or death, is extremely small. Getting hepatitis A vaccine is much safer than getting the disease.

    Mild Problems:

    • soreness where the shot was given (about 1 out of 2 adults, and up to 1 out of 6 children)
    • headache (about 1 out of 6 adults and 1 out of 25 children)
    • loss of appetite (about 1 out of 12 children)
    • tiredness (about 1 out of 14 adults)
    If these problems occur, they usually last 1 or 2 days.

    Severe problems:

    • serious allergic reaction, within a few minutes to a few hours of the shot (very rare).

    What if there is a moderate or severe reaction?

    What should I look for?

    • Any unusual condition, such as a high fever or unusual behavior. Signs of a serious allergic reaction can include difficulty breathing, hoarseness or wheezing, hives, paleness, weakness, a fast heart beat or dizziness.

    What should I do?

    • Call a doctor, or get the person to a doctor right away.
    • Tell your doctor what happened, the date and time it happened, and when the vaccination was given.
    • Ask your doctor, nurse, or health department to report the reaction by filing a Vaccine Adverse Event Reporting System (VAERS) form. Or you can fi le this report through the VAERS web site at http://www.vaers.hhs.gov , or by calling 1-800-822-7967.
    VAERS does not provide medical advice.

    The National Vaccine Injury Compensation Program

    • Ask your doctor. They can give you the vaccine package insert or suggest other sources of information.
    • Call your local or state health department.
    • Contact the Centers for Disease Control and Prevention (CDC): Call 1-800-232-4636 (1-800-CDC-INFO) or visit CDC's website at http://www.cdc.gov/vaccines

    How can I learn more?

    • Ask your doctor or other healthcare provider. They can give you the vaccine package insert or suggest other sources of information.
    • Call your local or state health department's immunization program.
    • Contact the Centers for Disease Control and Prevention (CDC): call 1-800-232-4636 (1-800-CDC-INFO) or visit the National Immunization Program's website at http://www.cdc.gov/vaccines .
    Hepatitis A Vaccine Information Statement. U.S. Department of Health and Human Services/Centers for Disease Control and Prevention National Immunization Program. 10/25/2011.

    Brand Names

    • Havrix®
    • Vaqta®
    • Twinrix® (as a combination product containing Hepatitis A Vaccine, Hepatitis B Vaccine)

    Hepatitis B Vaccine

    What is hepatitis B?

    Hepatitis B is a serious infection that affects the liver. It is caused by the hepatitis B virus.
    • In 2009, about 38,000 people became infected with hepatitis B.
    • Each year about 2,000 to 4,000 people die in the United States from cirrhosis or liver cancer caused by hepatitis B.
    Hepatitis B can cause:

    Acute (short-term) illness:

    This can lead to:
    • loss of appetite
    • tiredness
    • pain in muscles, joints, and stomach
    • diarrhea and vomiting
    • jaundice (yellow skin or eyes)

    Chronic (long-term) infection:

    Some people go on to develop chronic hepatitis B infection. Most of them do not have symptoms, but the infection is still very serious, and can lead to:
    • liver damage (cirrhosis)
    • liver cancer
    • death
    Chronic infection is more common among infants and children than among adults. People who are chronically infected can spread hepatitis B virus to others, even if they don't look or feel sick. Up to 1.4 million people in the United States may have chronic hepatitis B infection.
    Hepatitis B virus is easily spread through contact with the blood or other body fluids of an infected person. People can also be infected from contact with a contaminated object, where the virus can live for up to 7 days.
    A baby whose mother is infected can be infected at birth; children, adolescents, and adults can become infected by:
    • contact with blood and body fluids through breaks in the skin such as bites, cuts, or sores
    • contact with objects that have blood or body fluids on them such as toothbrushes, razors, or monitoring and treatment devices for diabetes
    • having unprotected sex with an infected person
    • sharing needles when injecting drugs
    • being stuck with a used needle.

    Hepatitis B vaccine: Why get vaccinated?

    Hepatitis B vaccine can prevent hepatitis B, and the serious consequences of hepatitis B infection, including liver cancer and cirrhosis.
    Hepatitis B vaccine may be given by itself or in the same shot with other vaccines.
    Routine hepatitis B vaccination was recommended for some U.S. adults and children beginning in 1982, and for all children in 1991. Since 1990, new hepatitis B infections among children and adolescents have dropped by more than 95%, and by 75% in other age groups.
    Vaccination gives long-term protection from hepatitis B infection, possibly lifelong.

    Who should get hepatitis B vaccine and when?

    Children and Adolescents:

    Babies normally get 3 doses of hepatitis B vaccine:
    • 1st Dose: Birth
    • 2nd Dose: 1 to 2 months of age
    • 3rd Dose: 6 to 18 months of age
    Some babies might get 4 doses, for example, if a combination vaccine containing hepatitis B is used. (This is a single shot containing several vaccines.) The extra dose is not harmful.
    Anyone through 18 years of age who didn't get the vaccine when they were younger should also be vaccinated.

    Adults:

    All unvaccinated adults at risk for hepatitis B infection should be vaccinated. This includes:
    • sex partners of people infected with hepatitis B
    • men who have sex with men
    • people who inject street drugs
    • people with more than one sex partner
    • people with chronic liver or kidney disease
    • people under 60 years of age with diabetes
    • people with jobs that expose them to human blood or other body fluids
    • household contacts of people infected with hepatitis B
    • residents and staff in institutions for the developmentally disabled
    • kidney dialysis patients
    • people who travel to countries where hepatitis B is common
    • people with HIV infection.
    • Other people may be encouraged by their doctor to get hepatitis B vaccine; for example, adults 60 and older with diabetes. Anyone else who wants to be protected from hepatitis B infection may get the vaccine.
    • Pregnant women who are at risk for one of the reasons stated above should be vaccinated. Other pregnant women who want protection may be vaccinated.
    Adults getting hepatitis B vaccine should get 3 doses, with the second dose given 4 weeks after the first and the third dose 5 months after the second. Your doctor can tell you about other dosing schedules that might be used in certain circumstances.

    Who should not get hepatitis B vaccine?

    • Anyone with a life-threatening allergy to yeast, or to any other component of the vaccine, should not get hepatitis B vaccine. Tell your doctor if you have any severe allergies.
    • Anyone who has had a life-threatening allergic reaction to a previous dose of hepatitis B vaccine should not get another dose.
    • Anyone who is moderately or severely ill when a dose of vaccine is scheduled should probably wait until they recover before getting the vaccine.
    Your doctor can give you more information about these precautions.
    Note: You might be asked to wait 28 days before donating blood after getting hepatitis B vaccine. This is because the screening test could mistake vaccine in the bloodstream (which is not infectious) for hepatitis B infection.

    What are the risks from hepatitis B vaccine?

    Hepatitis B is a very safe vaccine. Most people do not have any problems with it.
    The vaccine contains non-infectious material, and cannot cause hepatitis B infection.
    Some mild problems have been reported:
    • Soreness where the shot was given (up to about 1 person in 4).
    • Temperature of 99.9 °F (37.7 °C) or higher (up to about 1 person in 15).
    Severe problems are extremely rare. Severe allergic reactions are believed to occur about once in 1.1 million doses.
    A vaccine, like any medicine, could cause a serious reaction. But the risk of a vaccine causing serious harm, or death, is extremely small. More than 100 million people in the United States have been vaccinated with hepatitis B vaccine.

    What if there is a moderate or severe reaction?

    What should I look for?

    • Any unusual condition, such as a high fever or unusual behavior. Signs of a serious allergic reaction can include difficulty breathing, hoarseness or wheezing, hives, paleness, weakness, a fast heart beat or dizziness.

    What should I do?

    • Call a doctor, or get the person to a doctor right away.
    • Tell your doctor what happened, the date and time it happened, and when the vaccination was given.
    • Ask your doctor, nurse, or health department to report the reaction by filing a Vaccine Adverse Event Reporting System (VAERS) form. Or you can file this report through the VAERS web site at http://www.vaers.hhs.gov , or by calling 1-800-822-7967.
    VAERS does not provide medical advice.

    The National Vaccine Injury Compensation Program

    The National Vaccine Injury Compensation Program (VICP) was created in 1986.
    Persons who believe they may have been injured by a vaccine can learn about the program and about filing a claim by calling 1-800-338-2382 or visiting the VICP website at http://www.hrsa.gov/vaccinecompensation .

    How can I learn more?

    • Ask your doctor. They can give you the vaccine package insert or suggest other sources of information.
    • Call your local or state health department.
    • Contact the Centers for Disease Control and Prevention (CDC): Call 1-800-232-4636 (1-800-CDC-INFO) or visit CDC's website at http://www.cdc.gov/vaccines .
    Hepatitis B Vaccine Information Statement. U.S. Department of Health and Human Services/Centers for Disease Control and Prevention National Immunization Program. 2/2/2012.

    Brand Names

    • Engerix-B®
    • Recombivax HB®
    • Comvax®
    • Twinrix® (as a combination product containing Hepatitis A Vaccine, Hepatitis B Vaccine)
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