CKS is no longer commissioned by the National Institute for Health and Clinical Excellence (NICE). NICE remains committed to providing a replacement service for CKS and is currently reviewing its options. In the meantime, although CKS content is now not being maintained, it still remains relevant and will continue to be made available. CKS content was generated under a programme of topic creation and update. To check if the topic you are viewing is current or out of date, please refer to the topic publication details by clicking on the 'How up-to-date is this topic?' link in the left hand menu on individual topic pages.
Immunizations - travel vaccinations - Management
View full scenario
Definition
- Hepatitis A is an infection of the liver caused by hepatitis A virus. It is transmitted by the faecal–oral route through person-to-person contact and through contaminated food or drink.
When is hepatitis A vaccine indicated?
- Anyone 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.
In depth
What types of hepatitis A vaccine are available
- There are several inactivated hepatitis A vaccines available: Avaxim®, Epaxal®, Havrix Monodose®, Vaqta Paediatric®, Twinrix® (hepatitis A and B), and combined hepatitis A and typhoid (Hepatytix®and ViATIM®).
In depth
What schedule is used for hepatitis A vaccine?
- Should be given at least 2 weeks before travelling, but can be given on the day of departure.
Table 1. Schedule for currently-available hepatitis A vaccinations.
Vaccine | Schedule | Age |
|---|
Avaxim® | 2 doses, given 6–12 months apart. | 16 years and older. |
Epaxal® | 2 doses, given 6–12 months apart. | 12 months and older. |
Havrix Monodose® | 2 doses, given 6–12 months apart. | 16 years and older. |
Havrix Junior Monodose® | 2 doses, given 6–12 months apart. | From 12 months to 17 years. |
Vaqta Paediatric® | 2 doses, given 6–12 months apart. | Children from 12 months to 17 years. |
- 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.
In depth
What are the adverse effects of hepatitis A vaccine?
- Mild, transient soreness, erythema, and induration at the injection site may occur. A small, painless nodule may form at the injection site; this usually disappears and is of no consequence.
- Fever, malaise, fatigue, headache, nausea, and loss of appetite are rare.
In depth
Prescriptions
Hepatitis A vaccine - children
Age from 1 year to 15 years 11 months
Hepatitis A vaccine (Epaxal)
Epaxal emulsion for injection 0.5ml pre-filled syringes
Give 0.5ml by intramuscular injection.
Supply 1 0.5ml prefilled syringe.
Hepatitis A vaccine (Havrix Junior Monodose)
Havrix Junior Monodose suspension for injection 0.5ml pre-filled syringes
Give 0.5ml by intramuscular injection.
Supply 1 0.5ml prefilled syringe.
Age from 1 year to 17 years
Hepatitis A vaccine (Vaqta Paediatric)
VAQTA Paediatric suspension for injection 0.5ml pre-filled syringes
Give 0.5ml by intramuscular injection.
Supply 1 0.5ml prefilled syringe.
Hepatitis A vaccine - adults
Age from 16 years onwards
Hepatitis A vaccine (Epaxal)
Epaxal emulsion for injection 0.5ml pre-filled syringes
Give 0.5ml by intramuscular injection.
Supply 1 0.5ml prefilled syringe.
Hepatitis A vaccine (Havrix Monodose)
Havrix Monodose suspension for injection 1ml pre-filled syringes
Give 1ml by intramuscular injection.
Supply 1 1ml prefilled syringe.
Hepatitis A vaccine (Avaxim)
Avaxim suspension for injection 0.5ml pre-filled syringes
Give 0.5ml by intramuscular injection.
Supply 1 0.5ml prefilled syringe.
Hepatitis A and typhoid combined vaccine
Age from 15 years onwards
Hepatitis A + typhoid vaccine (Hepatyrix)
Hepatyrix suspension for injection 1ml pre-filled syringes
Give 1ml by intramuscular injection.
Supply 1 1ml prefilled syringe.
Age from 16 years onwards
Hepatitis A + typhoid vaccine (ViATIM)
ViATIM suspension for injection 1ml pre-filled syringes
Give 1ml by intramuscular injection.
Supply 1 1ml prefilled syringe.
Hepatitis A and hepatitis B combined vaccine
Age from 1 year to 15 years 11 months
Hepatitis A + hepatitis B vaccine (Twinrix Paed)
Twinrix Paediatric suspension for injection 0.5ml pre-filled syringes
Give 0.5 ml by intramuscular injection. Give a second dose one month later, then give a third dose 6 months after the first dose.
Supply 1 0.5ml prefilled syringe.
Hepatitis A + hepatitis B vaccine (Ambirix)
Ambirix vaccine suspension for injection 1ml pre-filled syringes
Give 1ml by intramuscular injection.
Supply 1 1ml prefilled syringe.
Age from 16 years onwards
Hepatitis A + hepatitis B vaccine (Twinrix Adult)
Twinrix Adult suspension for injection 1ml pre-filled syringes
Give 1 ml by intramuscular injection. Give a second dose one month later, then give a third dose 6 months after the first dose.
Supply 1 1ml prefilled syringe.
Hepatitis A + hepatitis B combined: rapid schedule
Age from 1 year to 15 years 11 months
Hepatitis A + hepatitis B vaccine (Ambirix)
Ambirix vaccine suspension for injection 1ml pre-filled syringes
Give 1ml by intramuscular injection.
Supply 1 1ml prefilled syringe.
Age from 16 years onwards
Hepatitis A + hepatitis B vaccine: rapid schedule
Twinrix Adult suspension for injection 1ml pre-filled syringes
Give 1ml by intramuscular injection. For rapid primary immunization, give 3 doses on days 0, 7, and 21.
Supply 1 1ml prefilled syringe.
© NHS Institute for Innovation and Improvement