Vaccines to Prevent Hepatitis A

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The best way to prevent hepatitis A is through vaccination with the hepatitis A vaccine. Vaccination is recommended for all children age 12 months and older, for travelers to certain countries, and for people at high risk for infection with the virus.

The hepatitis A vaccine is given as two shots, six months apart. The hepatitis A vaccine also comes in a combination form, containing both hepatitis A and B vaccine, that can be given to persons 18 years of age and older. This form is given as three shots, over a period of six months or as three shots over one month and a booster shot at 12 months.

FOR CHILDREN
The first dose should be given at 12-23 months of age. Children who are not vaccinated by two years of age can be vaccinated at later visits.

FOR TRAVELERS
The first dose of hepatitis A vaccine is recommended for healthy international travelers younger than 40 years of age at any time before departure. A shot called immune globulin (IG) can be considered in addition to hepatitis A vaccine for older adults, immunocompromised persons, and persons with chronic liver disease or other chronic medical conditions who are traveling within two weeks.

IG without hepatitis A vaccine can be given to travelers who are younger than 12 months of age, allergic to a vaccine component, or who elect not to receive vaccine.

FOR OTHERS
The hepatitis A vaccine series may be started whenever a person is at risk of infection:

Men who have sexual contact with other men Users of certain illegal drugs, both injection and non-injection Family and caregivers before arrival of international adoptees People with chronic (lifelong) liver diseases, such as hepatitis B or hepatitis C People who are treated with clotting-factor concentrates People who work with hepatitis A infected animals or in a hepatitis A research laboratory SOME PEOPLE SHOULD NOT BE VACCINATED OR SHOULD WAIT TO GET VACCINATED 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. 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 or nurse. People with a mild illness can usually get the vaccine. Tell your doctor if you are pregnant. The safety of hepatitis A vaccine for pregnant women has not been determined. But there is no evidence that it is harmful to either pregnant women or their unborn babies. The risk, if any, is thought to be very low.

What is hepatitis A?

Hepatitis A is a viral disease that is common in developing countries and is generally associated with poor sanitation and poor hygiene. It is one of the most common vaccine-preventable illnesses in travellers.

What is my risk?
Your risk depends on several factors: destination, length of trip, and your living conditions.

The risk of hepatitis A is highest among travellers:

Visiting or living in rural areas Eating and drinking in locations with poor sanitation or unsafe food handling practices The risk of hepatitis A exists even for travellers going for short periods of time to urban areas, staying in luxury hotels and who follow good hygiene and water and food precautions.

 How is it transmitted?

The hepatitis A virus is found in the stool (feces) of an infected person.

It can be spread through contaminated food and water or through close contact with an infected person.

Certain uncooked foods such as shellfish, fruits or salads can be contaminated, as well as foods that are prepared in unsanitary conditions or by an infected person with unsafe food handling practices.

It can also be transmitted through close personal contact when poor hygiene is practised: in day cares, households, schools, etc.less commonly, through sexual contact. Infection with the virus gives lifelong immunity (protection) against the virus.

What are the symptoms?
Symptoms can take from 15 to 50 days to appear (average 28 days).

Some people who are infected have no symptoms, others may have only mild symptoms that last from 1 to 2 weeks and some may experience more severe symptoms that can last several months.

In children, symptoms are mild to non-existent. Severity of the illness increases with age.

Symptoms can include fever, fatigue, loss of appetite, nausea and vomiting, abdominal discomfort, dark urine and grey-colored stool, jaundice (yellowing of skin and whites of eyes).

In severe and rare occasions, symptoms can include liver damage, liver failure, or death. Individuals with pre-existing chronic liver disease and older people are most at risk for this.

Recovery generally takes a few weeks, but can take months. Most people recover without side effects and have lifelong immunity against hepatitis A.

Can hepatitis A be treated?
There is no treatment for hepatitis A, only supportive care to help relieve symptoms.

Where is hepatitis A a concern?
Hepatitis A occurs worldwide but is more common in regions with poor sanitation and lack of safe food and water.

Regions where there is a high risk of hepatitis A transmission include Africa, Asia and Central and South America.

A map of countries and areas of risk for hepatitis A is available on the World Health Organization (WHO) website.

Recommendations
Consult a health care provider or visit a travel health clinic preferably six weeks before you travel.

Practise safe food and water precautions  Wash your hands frequently Wash your hands with soap under warm running water for at least 20 seconds, as often as possible, including before eating or preparing food and after using the bathroom or changing diapers.  Use alcohol-based hand sanitizer if soap and water are not available. It’s a good idea to always keep some with you when you travel. Get vaccinated if you are at risk but are not immunized (either through previous vaccination or previous hepatitis A infection) Discuss the benefits of getting vaccinated with a health care provider before travelling if you are:  travelling to countries where hepatitis A occurs. visiting areas where drinking water may be unsafe and poor sanitation and hygiene conditions exist. Monitor your health If you develop symptoms similar to hepatitis A when you are travelling or after you return, see a health care provider and tell them where you have been travelling or living.