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Immunizations - travel vaccinations - Management
What schedule is used for hepatitis A vaccine?
- Hepatitis A single vaccine should be given at least 2 weeks before travelling but can be given up to the day of departure.
Table 1. Schedule for currently available hepatitis A vaccinations.
Vaccine | Schedule | Length of protection | Age |
|---|
Avaxim® | 2 doses, given 6–12 months apart. | 20 years after second dose. | Adults from 16 years. |
Epaxal® | 2 doses, given 6–12 months apart. | 20 years after second dose. | Adults and children from 12 months. |
Havrix Monodose® | 2 doses, given 6–12 months apart. | 20 years after second dose. | Adults from 16 years. |
Havrix Junior Monodose® | 2 doses, given 6–12 months apart. | 20 years after second dose. | Children from 12 months to 18 years. |
Vaqta Paediatric® | 2 doses, given 6–12 months apart. | 20 years after second dose. | Children from 12 months to 18 years. |
|
- If the second dose has been missed there is no need to restart immunization. Give the second dose as soon as possible after the missed date.
- If a combined hepatitis A and typhoid vaccine has been used to initiate immunization, give a dose of single hepatitis A vaccine 6–12 months later:
- A booster dose of the hepatitis A component is required 20 years after the second dose.
- A booster dose of the typhoid component will be required at 3 years.
- If a combined hepatitis A and B vaccine has been given in an accelerated schedule, a booster dose is required at 1 year.
Basis for recommendation
- These recommendations are based on expert opinion published in the medical literature [NaTHNaC, 2004d; DH, 2006c].
- Antibodies may not be detectable for 12–15 days following administration of monovalent hepatitis A vaccine, however the vaccine may provide some protection before antibodies can be detected [DH, 2006c].
- Ninety percent immunity occurs in 2 weeks.
- Although booster doses delayed beyond the recommended intervals are not covered by the product licence, a second dose given after a long interval will still boost the immune response [NaTHNaC, 2004d].
- A second dose of Havrix® given up to 8 years after the first dose boosted the primary dose. Good protective antibody levels have also been achieved when the second dose of Epaxal® was given up to 56 months after the primary dose.
- Thus, based on evidence from available studies, there is no interval which would require restarting a course of hepatitis A vaccine.
© NHS Institute for Innovation and Improvement