Hepatitis A Virus Vaccine Inactivated
Class: Vaccines
ATC Class: J07BC02
VA Class: IM100
Brands: Havrix, Vaqta
Introduction
Inactivated virus vaccine. Hepatitis A virus vaccine inactivated contains cell culture-adapted, attenuated hepatitis A virus (HAV) and is used to stimulate active immunity to HAV infection. Commercially available in the US as monovalent vaccines (HepA; Havrix, Vaqta) and in a fixed-combination vaccine with hepatitis B vaccine (HepA-HepB; Twinrix).
Uses for Hepatitis A Virus Vaccine Inactivated
Prevention of Hepatitis A Virus (HAV) Infection
Prevention of HAV infection in adults, adolescents, and children ≥1 year of age.
Although HAV infection may be asymptomatic or relatively mild in many patients, it can result in substantial morbidity and associated health-care costs and work loss (11–22% of patients require hospitalization) and may be associated with fulminant hepatitis and hepatic failure. Overall HAV case-fatality rate in the US is 0.3–0.6%, but increases to about 2% in those ≥40 years of age. HAV is highly contagious (especially during the 2 weeks before onset of symptoms). The virus is transmitted person-to-person, principally through the fecal-oral route. HAV infection remains one of the most commonly reported vaccine-preventable diseases in travelers.
USPHS Advisory Committee on Immunization Practices (ACIP), AAP, and American Academy of Family Physicians (AAFP) recommend that all children be vaccinated against HAV infection at 1 year of age (i.e., 12 through 23 months of age), unless contraindicated. (See Contraindications under Cautions.)
ACIP, AAP, AAFP, American College of Obstetricians and Gynecologists (ACOG), and American College of Physicians (ACP) also recommend vaccination against HAV for all previously unvaccinated children, adolescents, and adults at high risk of exposure to HAV (see Preexposure Vaccination Against HAV Infection in High-risk Groups under Uses) and for any other unvaccinated individual desiring protection from HAV infection.
For internationally adopted children whose immune status is uncertain, vaccinations can be repeated or serologic tests performed to confirm immunity. For HepA vaccine, ACIP states that the simplest approach is to revaccinate according to the US recommended immunization schedule if child is ≥12 months of age. (See Dosage and Administration.) Alternatively, test for serologic evidence of susceptibility to HAV. (See Pre-and Postvaccination Serologic Testing under Cautions.) When a child is being adopted from a country with high or intermediate HAV endemicity, ACIP states that all previously unvaccinated individuals who anticipate close personal contact with the adoptee during the child’s initial 60 days in the US (e.g., household members, regular babysitters) should receive routine vaccination with HepA vaccine, with the first dose given as soon as adoption is planned (ideally ≥2 weeks before the child’s arrival). CDC website ([Web]) has information regarding which countries ha...
