Yes. ACIP recommends that all children age 1 year through 18 years should be vaccinated against hepatitis A. VFC HepA vaccine may be administered to any eligible child, including those recommended for vaccination at 6 through 11 months of age as a result of travel to an HAV-endemic area.
It depends on whether that person has a history of HAV infection. Unless there are medical records that document prior HAV infection, serologic testing for immunity (positive test for total anti-HAV) is the only way to determine if vaccination is necessary. For people from countries with high rates of HAV infection, such as Vietnam and Mexico, serologic testing might be done to prevent unnecessary vaccination. The cost effectiveness of serologic testing, however, should be balanced against the possibility of delaying needed vaccination while awaiting test results.
No, as long as there are medical records that document that the person was previously infected with HAV (i.e., positive test for total anti-HAV). If there is any doubt that the person actually was infected with HAV, HepA vaccine and/or IG should be given. The vaccine or IG will not harm a person who is already immune.
No serious adverse events have been attributed definitively to HepA vaccine. Among adults, the most frequently reported side effects are soreness at the site of the injection and headache. In children, the most frequently reported side effect is soreness at the injection site. The frequency of side effects after administration of Twinrix is similar to those reported when the two single-antigen vaccines were administered.
Hepatitis A vaccine is contraindicated for people with a history of a severe allergic reaction to a previous dose of HepA vaccine or to a vaccine component. As with all other vaccines, there is a precaution when giving it to anyone who is moderately or severely ill.
Yes. ACIP recommends that pregnant women at risk for HAV infection during pregnancy or at risk for a severe outcome from HAV infection should be vaccinated during pregnancy if not previously vaccinated. Pregnant women should be vaccinated for the same indications as non-pregnant women. For additional details, see page 20 of the current ACIP recommendations: www.cdc.gov/mmwr/volumes/69/rr/pdfs/rr6905a1-H.pdf.
Yes. HepA vaccine is an inactivated vaccine and poses no harm to the nursing infant.
Yes. All people age 1 year or older living with HIV infection should be vaccinated against hepatitis A if they have not been vaccinated, regardless of their CD4+ count.
If any immunocompromised person has a risk factor that places them at increased risk of hepatitis A (e.g., international travel, drug use), they should be vaccinated with HepA vaccine.
Yes. HepA vaccine should be given to all susceptible patients with chronic liver disease. HepA vaccine is very immunogenic.
All hepatitis A-containing vaccine should be stored at refrigerator temperature at 2°C to 8°C (36°F to 46°F). The vaccine must not be frozen. Any vaccine exposed to freezing temperature should not be used. Do not use these or any other vaccines after the expiration date shown on the packaging. Any vaccine administered after its expiration date is not valid and should be repeated.