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Immunizations - travel vaccinations - Management
When is hepatitis A vaccine indicated?

  • Anyone aged 1 year and over travelling to areas of moderate or high risk (Indian subcontinent, the Far East, and Eastern Europe) for prolonged periods, particularly if sanitation and food hygiene is likely to be poor.
  • Individuals going to live in, or likely to be posted for long periods to, hepatitis A virus-endemic countries.
  • People with chronic liver disease, as they are especially at risk.
  • Give combined vaccines if:
    • Protection against both hepatitis A and hepatitis B infections is required, OR
    • Protection against hepatitis A and typhoid fever is required (frequently endemic in the same areas).
  • If rapid protection against hepatitis A is required, for example following exposure or during outbreaks, then a single dose of monovalent vaccine is preferred as this may provide protection more quickly than the two courses of combined vaccine.
  • Immunization is not considered necessary for individuals travelling to or going to reside in Northern or Western Europe (including Spain, Portugal, and Italy), or North America, Australia, or New Zealand.
  • Hepatitis A immunoglobulin is no longer recommended for travel prophylaxis.
  • For up to date country by country advice see NaTHNaC, and, Travax websites.
Clarification / Additional information
  • Other specific indications for hepatitis A vaccination can be found in Immunisation against infectious disease 'Green Book'.
Basis for recommendation
  • These recommendations are based on expert advice from the published medical literature [DH, 2006c].
  • The risks of hepatitis A in children under 1 year old are low, and hepatitis A vaccines are not licensed for use in this age group.

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