Hep a vaccine side effects in toddlers


Vaccine (Shot) for Hepatitis A

The hepatitis A shot is safe.

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The hepatitis A vaccine is very safe, and it is effective at preventing the hepatitis A disease. Vaccines, like any medicine, can have side effects. These are usually mild and go away on their own.

What are the side effects?

The most common side effects are usually mild and last 1 or 2 days. They include:

  • Sore arm from the shot
  • Headache
  • Tiredness
  • Fever
  • Loss of appetite (not wanting to eat)

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Prepare for your child’s vaccine visit and learn about how you can:

  • Research vaccines and ready your child before the visit
  • Comfort your child during the appointment
  • Care for your child after the shot

Before, During, and After Shots

What is hepatitis A?

Hepatitis A is a serious liver disease caused by the hepatitis A virus. Children with the virus often don’t have symptoms, but they often pass the disease to others, including their unvaccinated parents or caregivers. These individuals can get very sick.

What are the symptoms of hepatitis A disease?

Children under 6 years old often have no symptoms. Older children and adults feel
very sick and weak. Symptoms usually appear 2 to 6 weeks after a person gets the virus.
The symptoms may include

  • Fever
  • Loss of appetite (not wanting to eat)
  • Tiredness
  • Stomach pain
  • Vomiting
  • Dark urine
  • Yellow skin and eyes

Is it serious?

Older children, adolescents and adults often feel sick and symptoms can last for up to 6 months. There is no specific treatment for hepatitis A.

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Hepatitis A is a serious disease that used to be more common in the United States. In the 1980s, the United States used to see as many as 30,000 cases a year. Thanks to the vaccine, the number of hepatitis A cases in the United States has dropped by 95%.

How does hepatitis A spread?

Hepatitis A virus is found in the stool (poop) of a person who has the virus. It spreads when a person puts something in his or her mouth that has the hepatitis A virus on it. Even if the item looks clean, it can still have virus on it that can spread to others. The amount of stool can be so tiny that it cannot be seen with the naked eye. You can get it by touching objects such as doorknobs or diapers or eating food that has the virus on it.

Follow the vaccine schedule

The Centers for Disease Control and Prevention, American Academy of Family Physicians, and American Academy of Pediatrics strongly recommend children receive all vaccines according to the recommended vaccine schedule.

  • Get a list of vaccines that your child may need based on age, health conditions, and other factors.
  • Learn the reasons you should follow the vaccine schedule.

What are the benefits of the hepatitis A vaccine?

This vaccine (HepA) protects your child against the hepatitis A virus, which causes a liver disease. The long-term physical consequences of hepatitis A are usually far less serious than those of hepatitis B or C. Still, a bout of hepatitis A is no fun, and the worst cases can cause liver damage and even death.

In 2014, there were an estimated 2,500 new hepatitis A virus infections in the United States. But because many people – particularly children – show no symptoms, it’s hard to know exactly how many people are infected each year. The good news is that rates of hepatitis A in the United States are the lowest they’ve been in over 40 years, thanks to the vaccine.

The hepatitis A virus is carried in feces and may be transmitted by unwashed hands, so it spreads easily in daycare centers and other places where children play together. For example, a caregiver may help an infected child use the bathroom, forget to wash her hands, and then transmit the virus by touching her own mouth or another child’s mouth.

Hepatitis A also is transmitted through contaminated food and water. The virus is very hardy and can survive for months on exposed surfaces, in raw foods, and in sewage.

The virus may cause symptoms such as fever, fatigue, nausea, vomiting, abdominal pain, dark urine, and sometimes jaundice. It doesn’t always cause symptoms, though, especially in children.

There’s no treatment for the illness, but most children recover on their own within two months. About 15 percent of those infected have ongoing or relapsing symptoms for six months. A very small number of cases of hepatitis A in the United States are fatal.

For all these reasons, the vaccine is now part of the recommended vaccine schedule in the United States.

See which shots are recommended and get a personalized schedule for your child’s immunizations.

What’s the recommended schedule?

Recommended number of doses

Two shots, six to 18 months apart

Recommended ages

First dose between the first and second birthdays (ages 12 to 23 months) with the second dose given six to 18 months later.

Children who haven’t had their first dose by 23 months can still be vaccinated.

To track your child’s immunizations, use BabyCenter’s Immunization Scheduler.

Who should not get the hepatitis A vaccine?

A child who has a severe allergic reaction to the vaccine after the first shot should not receive another. Neither should a child who is severely allergic to latex or hypersensitive to aluminum hydroxide, a metal used in the hepatitis A vaccine to ensure a better immune response, or to 2-phenoxyethanol, a preservative used in some hepatitis A vaccines.

Are there any precautions I should take?

This vaccine is so mild that kids can get it even if they’re feeling slightly under the weather. But if your child is suffering from a moderate to severe illness, wait until he’s feeling better.

What are the possible side effects?

About 15 percent of children feel sore at the injection site. A few experience loss of appetite or a headache.

Severe allergic reactions are rare but possible with any vaccine. See what our expert says about how to tell whether your child is having an adverse reaction.

If your child has an adverse reaction to this or any other vaccine, talk to your child’s doctor and report it to the Vaccine Adverse Event Reporting System.


Impact of hepatitis A vaccination: outbreak control and routine immunization

Industrialized countries usually belong to low or very low endemicity regions, but several examples exist of particular areas within these nations characterized by an intermediate endemicity pattern. For example, Puglia in Italy, Catalonia in Spain, the North Bohemian region in the Czech Republic, the south-western states and Alaska in the USA, the whole state of Israel, can be considered as areas where the periodical occurrence of large outbreaks or even epidemics make hepatitis A an important public health issue.

The World Health Organization recommends that hepatitis A vaccination be considered for introduction into routine childhood immunization schedules in countries at intermediate endemicity of infection where hepatitis A represents a significant public health problem. Economic and epidemiological studies should precede decisions on universal vaccination policies (WHO 2000). In other low endemicity countries, hepatitis A vaccine should be administered to subjects belonging to high risk groups like international travelers, military personnel involved in missions abroad, children of immigrant families, intravenous drug users, patients with clotting factor disorders, patients affected with chronic hepatitis, homosexual men, and so on. Some countries also have recommendations for use of hepatitis A vaccination during outbreaks.

Policies of immunization targeted at risk groups, while effective for individual protection, usually fail to control the spread of an infectious agent on a community basis due to the difficulty in identifying those at risk and in effectively implementing their vaccination (as already demonstrated in the past by the experience with hepatitis B vaccine) (Bonanni 1995). Nevertheless, where routine vaccination programs against hepatitis A are not applied due to generally low endemicity but with periodic outbreaks, immunization of those in close contact with cases has proved useful in shortening outbreak duration, provided that a sufficient proportion of subjects is reached by immunization.

In areas at high endemicity for HAV infection, some experiences of control of epidemics using standard immune globulins had demonstrated the inability of such preventive means to get a long-lasting effect (Shaw et al 1986).

The first attempt to stop an outbreak by using a vaccine dates back to 1992, in Alaska, when immunization with a single dose was widely offered to all subjects under 40 years of age, to nonimmune older individuals in the Tok/Glenallen area, to all subjects under 20, and to seronegative subjects in the age range 20–34 in the Kotzebue area. It was possible to demonstrate that the attack rate of HAV infection in the first 60 weeks following vaccination was 12% in unimmunized subjects and 2.1% in vaccinees (most cases occurring few days after active immunization, ie, they were vaccinated during the incubation period). In the Kotzebue area, where only about 50% of eligible individuals were immunized, the epidemic persisted for several weeks, while in the surrounding regions, where coverage reached 80%, the epidemic was virtually eliminated within 8 weeks from the start of vaccination program (Mc Mahon et al 1996).

Other experiences in communities of American Indians showed that routine vaccination of children can interrupt already occurring epidemics, and that keeping up coverage prevents the start of new epidemics (CDC 1999).

In Europe, an intervention conducted in two villages in Slovakia where an epidemic was occurring (121 cases between December 1991 and March 1993, 62 of which in schoolchildren), caused its extinction two months after 2/3 of children were immunized with two doses of vaccine, with only nine further cases before the end of the epidemic in March 1993, 8 of which were in the nonvaccinated group (Prikazsky et al 1994).

Several outbreaks have occurred in Europe originating in day-care centers, and maternal or primary schools (sometimes with spread to the larger community) where vaccination was used in the attempt to shorten the duration of such episodes.

Almost all outbreaks of this kind originate from children of immigrant families born in their adoptive country who periodically travel back (usually in summer) to their country of origin to visit relatives. The infected children are contagious when school activities start again, and characteristic patterns of HAV transmission to indigenous European children and to the parents (typically about 1 month after the wave in children) are observed (van Gorkom et al 1998).

The 11 cases (5 in children and 6 in household contacts) detected in a nursery school in Central Italy resulted in one of the first attempts to stop imported outbreaks in schools by using hepatitis A vaccination. The program of immunization was accepted by almost all other schoolchildren and school personnel, and by 11/36 cohabitant children and 10/78 cohabitant adults of cases. The last case was detected two months after the start of vaccination, a considerably shorter interval compared to previous similar outbreaks (Bonanni et al 1998).

More recently, two outbreaks (again originating from immigrant children) occurred almost simultaneously on two sides of the city of Florence, Italy, but had very different outcomes. During the first outbreak on the southeastern side of the city, the index case was identified with considerable delay, and the immunization program of case contacts started late as a result of poor communication within the local health unit and the unavailability of a sufficient number of doses. Compliance with the Italian guidelines on hepatitis A vaccine use, which suggest waiting for a second case to occur in secondary schools before starting vaccination of contacts, meant that the infection spread to adolescents and their relatives. Overall, 30 clinically overt cases and 7 asymptomatic infections were detected, and the outbreak lasted for 6 months. On the other hand, a potential outbreak in a maternal school was stopped in the northwestern part of the city because a vaccination program of other schoolchildren and of contacts of the index case was immediately implemented, reaching >80% coverage. Only 3 cases of hepatitis A occurred, one of which may have been connected to other sources of infection. Comparing the two outbreaks enables us to draw some conclusions on the use of hepatitis A vaccine to stop the virus spreading in schools and households. Most important is timely diagnosis of hepatitis A by general practitioners, improved communication channels within the health care setting, the availability of a sufficient number of vaccine doses in every health district for immediate use in case of an outbreak, and the offer of immunization to case contacts irrespective of a presumed ‘low-risk’ environment, such as secondary schools (Bonanni et al 2005).

To establish individual protection by hepatitis A vaccine in post-exposure prophylaxis, Hepatitis A vaccine was used in HAV susceptible family contacts of acute hepatitis A cases (173 vaccinated and 178 unvaccinated) in a randomized, controlled trial.

Hepatitis A vaccine showed an 82% protective efficacy (95% CI: 20%–96%) in the prevention of secondary cases (79%; 95% CI: 7%–95%, when households were analysed). About 56% of subjects had been immunised within 4 days from the onset of symptoms in primary cases, and 100% within 8 days. Vaccination was required in 18 participants to prevent one secondary infection (Sagliocca et al 1999).

Evidence that clinical disease does not occur at antibody levels lower than those currently accepted as protective, that hepatitis A vaccine has proved effective in controlling outbreaks, and that timely immunization can prevent secondary infections within households, strongly suggests the usefulness of immunization against hepatitis A in traveler children, even for last-minute departures (Connor 2005).

In the last 10 years, the health authorities of some of the countries mentioned above, characterized by generally low endemicity but with areas at intermediate endemicity, introduced universal immunization policies with different target populations. We can now evaluate the epidemiological effects of such decisions.

In the United States in 1999, the Advisory Committee on Immunization Practices (ACIP) issued new recommendations on the public health use of hepatitis A vaccine, amending those of 1996 which focused on vaccinating subjects at risk. The ACIP stated that “… a review of the national epidemiologic data indicates that continued implementation of these recommendations would not result in vaccination of most populations with consistently elevated rates of disease and therefore would have a limited impact on the overall incidence of disease in the United States. To achieve a sustained reduction in HAV rates, a shift is needed to one that achieves widespread routine vaccination of children to prevent infection in these age groups and eventually among older persons.”

As a consequence, routine vaccination of children was recommended in states, counties and communities with rates of infection more than double the national average (≥20 cases per 100,000 population) and should also be considered if infection rates were ≥10 cases but <20 cases per 100,000 population (CDC 1999). These recommendations recognized both the role that children play in transmitting HAV to others and the value of population-level action (Poland 2005).

A recently published study aimed at assessing the impact of the current vaccination strategy by evaluating trends in reported cases of hepatitis A since implementation of the recommendations (Wasley et al 2005). Incidence rates in 2003 were compared with those for the prevaccination baseline period (1990–1997) overall and in the 17 states in which children should routinely be vaccinated, or considered for routine vaccination (vaccinating states). Incidence rates in vaccinating states were also compared with those in the remaining states where there is no recommendation for statewide vaccination of children (non-vaccinating states). Between the baseline period (1990–1997) and 2003, overall hepatitis A rates declined 76% to 2.6 per 100,000, significantly lower than previous lowest points in 1983 (9.2/100,000) and 1992 (9.1/100,000). The rate in vaccinating states declined 88% to 2.5 per 100,000 compared with 53% elsewhere (to 2.7/100,000). Declines were greater among children aged 2 to 18 years (87%) than among persons older than age 18 years (69%); the proportion of cases in children dropped from 35% to 19%. Since 2001, rates in adults have been higher than among children, with the highest rates now among men aged 25 through 39 years.

After implementation of routine hepatitis A vaccination of children, hepatitis A rates have declined to historic lows, accompanied by substantial changes in the epidemiologic profile. Although the precise contribution of vaccination is difficult to assess, given the unavailability of detailed data on vaccination coverage in different states and areas, nevertheless the declines of incidence registered after 1999 have been unprecedented in magnitude and greater in areas in which vaccination of children is occurring.

As a consequence of the documented impact of hepatitis A vaccination on HAV epidemiology, the US health authorities very recently extended the recommendations for hepatitis A routine immunization. Hepatitis A vaccination is now recommended for all children at age 1 year (ie, 12–23 months). The 2 doses in the series should be administered at least 6 months apart. States, counties, and communities with existing hepatitis A vaccination programs for children aged 2–18 years are encouraged to maintain these programs. In these areas, new efforts focused on routine vaccination of children aged 1 year should enhance, not replace, ongoing programs directed at a broader population of children (CDC 2006).

Another proof of the impact of routine vaccination programs against hepatitis A on the epidemiology of this infection comes from the Israeli experience. In Israel, the mean annual incidence of hepatitis A disease was 50.4 per 100,000 during 1993–98. A 2-dose universal hepatitis A immunization program aimed at children aged 18–24 months (without a catch-up campaign) was started in 1999. Incidence of reported hepatitis A disease was monitored in the years 1993–2004. Overall vaccine coverage in Israel in 2001–02 was 90% for the first dose and 85% for the second dose. A decline in disease rates was observed before 1999 among the Jewish but not the non-Jewish population. After initiation of the program, a sharp decrease in disease rates was observed in both populations. The annual incidence of 2.2 to 2.5 per 100,000 during 2002–04 represents a 95% or greater reduction for each year with respect to the mean incidence during 1993–98 (p < 0.001).

For children aged 1 through 4 years, a 98.2% reduction in disease was observed in 2002–04, compared with the pre-vaccination period (p < 0.001). However, a sharp decline was also observed in all other age groups. In the Jewish population in the Jerusalem district, among whom an active surveillance program was successfully conducted, a more than 90% reduction of disease was demonstrated. Of the 433 cases reported nationwide in 2002–04 in whom vaccination status could be ascertained, 424 (97.9%) received no vaccine and none received 2 doses. This universal toddlers-only immunization program in Israel demonstrated not only high effectiveness of hepatitis A vaccination but also marked herd protection, challenging the need for catch-up hepatitis A vaccination programs (Dagan et al 2005).

Similar results were obtained in Puglia, Italy and in Catatonia, Spain, where routine vaccination of children in the second year of life (Puglia) and/or at adolescent age (Puglia and Catatonia) concomitantly with hepatitis B vaccination were recommended at the end of the 1990s (Lopalco et al 2000). Epidemiologic surveillance shows that peaks of hepatitis A incidence cyclically occurring in the past, were no longer observed in these areas.

Who Should Get the Hepatitis A Vaccine?

The CDC recommends that all children between ages 12 months and 23 months get this vaccine as well as for any infant aged 6 to 11 months who is traveling internationally.

The following people are also at risk for the disease and should be vaccinated:

  • Children and teens through age 18 who live in states or communities that have made this vaccination routine because of a high rate of disease
  • Men who have sex with men
  • Anyone who uses illegal drugs
  • People with chronic (long-term) liver disease
  • Anyone treated with blood clotting drugs, such as people with hemophilia
  • People who work with HAV-infected primates or in HAV research laboratories. (HAV is like HIV in animals.)
  • Travelers to countries where hepatitis A is common. A good source to check is the CDC’s travelers’ health website, which you can search by the country you’re going to.
  • People adopting or close to a child adopted from a country where hepatitis A is common

You should not get the vaccine if you’re allergic to any ingredients in it or if you had a severe allergic reaction to an earlier dose of it. Tell your doctor or pharmacist about any allergies you have.

If you’re pregnant, let your doctor know. The safety of this vaccine for pregnant women is unknown, although the risk is considered to be very low.

Hepatitis A


Two types of HAV vaccines are currently available internationally:

  • Formaldehyde-inactivated vaccines: Inactivated HAV vaccines are used in most countries. Monovalent inactivated HAV vaccines are available in paediatric dose (0.5 ml) for children aged 1 year to 15 years, and in adult dose (1 ml).
  • Live attenuated vaccines (based on H2 or LA-1 HAV strains): These vaccines are manufactured and used mainly in China and sporadically in the private sector in India.

1. Inactivated hepatitis A vaccines are safe and highly effective. Traditionally, a two-dose schedule is recommended, particularly in travellers at substantial risk of contracting hepatitis A and in immunocompromised individuals. However, in healthy individuals, comparable effectiveness has been achieved with a single dose. Results from mathematical models indicate that, after completion of the primary two-dose series, anti-HAV antibodies may persist for 25 years or more. Serological testing to assess antibody levels after vaccination is not indicated.

A combination hepatitis A/typhoid (ViCPS) vaccine, administered as a single dose, confers high levels of protection against both these waterborne diseases.

A combination vaccine that provides protection against both hepatitis A and hepatitis B should be considered for travellers who may be exposed to both organisms (see under Hepatitis B vaccines).

2. The Chinese live attenuated hepatitis A vaccines have been shown to be safe and highly protective (95%) against clinical infection for at least 3 years.

Type of vaccine: Inactivated or live, both given i.m.

Number of doses: Inactivated vaccine: two; live vaccine: one

Schedule:Inactivated vaccine: two doses, the second dose normally 6 months after the first. If needed, this interval may be extended to 18–36 months). In healthy individuals, a single dose seems to be similarly efficacious.
Live vaccine: one dose
Minimum age for HAV vaccination is 1 year

boosters: May not be necessary

Contraindications: Hypersensitivity to previous dose

Adverse reactions:Inactivated vaccine: mild local reaction of short duration, mild systemic reaction Live vaccine: few reported

Before departure:Inactivated and live vaccines: protection is achieved 2–4 weeks after first dose. Given the long incubation period of hepatitis A (average 2–4 weeks), the vaccine can be administered up to the day of departure and still protect travellers.

Recommended for: Hepatitis A vaccination should be considered for individuals aged ≥1 year who are travelling to countries or areas with moderate to high risk of infection. Those at high risk of acquiring severe disease, such as immunosuppressed patients and patients with chronic liver disease, should be strongly encouraged to be vaccinated regardless of where they travel.

Special precautions: None

Hepatitis A pediatric vaccine

Generic Name: hepatitis A pediatric vaccine (HEP a TYE tis)
Brand Name: Havrix Pediatric, Vaqta Pediatric

Medically reviewed by Drugs.com on Jul 23, 2019 – Written by Cerner Multum

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Important Information

You should not receive this vaccine if you have ever had a life-threatening allergic reaction to any vaccine containing hepatitis A, or if you are allergic to neomycin.

Before taking this medicine

Hepatitis A pediatric vaccine will not protect against infection with hepatitis B, C, and E, or other viruses that affect the liver. It may also not protect against hepatitis A if your child is already infected with the virus, even without showing symptoms.

Your child should not receive this vaccine if he or she has ever had a life-threatening allergic reaction to any vaccine containing hepatitis A, or if the child is allergic to neomycin.

Before receiving this vaccine, tell the doctor if your child has:

  • an allergy to latex rubber; or

  • a weak immune system (caused by disease or by using certain medicine.

Your child can still receive a vaccine if he or she has a minor cold. In the case of a more severe illness with a fever or any type of infection, wait until the child gets better before receiving this vaccine.

Hepatitis A vaccine is not approved for use by anyone younger than 12 months old.

How is this vaccine given?

This vaccine is given as an injection (shot) into a muscle. Your child will receive this injection in a doctor’s office or other clinic setting.

The hepatitis A pediatric vaccine is given in a series of 2 shots. The first shot is usually given when the child is between 12 and 23 months old. The booster shot is then given 6 months later.

Your child’s individual booster schedule may be different from these guidelines. Follow your doctor’s instructions or the schedule recommended by your local health department.

To prevent hepatitis A while traveling, the child should receive this vaccine at least 2 weeks before the trip. Your child’s doctor will determine the best dosing schedule for your situation.

Your doctor may recommend treating fever and pain with an aspirin free pain reliever such as acetaminophen (Tylenol) or ibuprofen (Motrin, Advil, and others) when the shot is given and for the next 24 hours. Follow the label directions or your doctor’s instructions about how much of hepatitis A pediatric vaccine to use.

What happens if I miss a dose?

Contact your doctor if you will miss a booster dose or if you get behind schedule. The next dose should be given as soon as possible. There is no need to start over.

Be sure your child receives all recommended doses of this vaccine, or the child may not be fully protected against disease.

What happens if I overdose?

An overdose of this vaccine is unlikely to occur.

What should I avoid before or after receiving this vaccine?

Follow your doctor’s instructions about any restrictions on food, beverages, or activity.

Hepatitis A pediatric vaccine side effects

Get emergency medical help if your child has signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Your child should not receive a booster vaccine if he or she had a life-threatening allergic reaction after the first shot.

Keep track of any and all side effects your child has after receiving this vaccine. When the child receives a booster dose, you will need to tell the doctor if the previous shot caused any side effects.

Becoming infected with hepatitis A is much more dangerous to your child’s health than receiving the vaccine to protect against it. Like any medicine, this vaccine can cause side effects, but the risk of serious side effects is extremely low.

Call your child’s doctor at once if the child has:

  • extreme drowsiness, fainting;

  • fussiness, irritability, crying for an hour or longer;

  • seizure (blackout-out or convulsions); or

  • high fever (within a few hours or a few days after the vaccine).

Common side effects may include:

  • low fever, general ill feeling;

  • nausea, loss of appetite;

  • headache; or

  • swelling, tenderness, redness, warmth, or a hard lump where the shot was given.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report vaccine side effects to the US Department of Health and Human Services at 1-800-822-7967.

Hepatitis A pediatric vaccine dosing information

Usual Pediatric Dose for Hepatitis A Prophylaxis:

1 year and older: 0.5 mL intramuscularly
-Administer a booster 0.5 mL dose 6 to 18 months after the first dose

-Administer in the deltoid region in children 2 years and older.
-Administer in the anterolateral aspect of the thigh in younger children.

What other drugs will affect hepatitis A pediatric vaccine?

Before receiving this vaccine, tell the doctor about all other vaccines your child has recently received.

Also tell the doctor if your child has recently received drugs or treatments that can weaken the immune system, including:

  • an oral, nasal, inhaled, or injectable steroid medicine;

  • medications to treat psoriasis, rheumatoid arthritis, or other autoimmune disorders; or

  • medicines to treat or prevent organ transplant rejection.

If your child is using any of these medications, he or she may not be able to receive the vaccine, or may need to wait until the other treatments are finished.

This list is not complete. Other drugs may interact with this vaccine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Copyright 1996-2018 Cerner Multum, Inc. Version: 6.01.

Medical Disclaimer

More about hepatitis a pediatric vaccine

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Other brands: Havrix Pediatric, Vaqta Pediatric

Related treatment guides

  • Hepatitis A Prophylaxis

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Hepatitis A, caused by infection with the Hepatitis A virus (HAV), has an incubation period of approximately 28 days (range: 15–50 days). HAV replicates in the liver and is shed in high concentrations in feces from 2 weeks before to 1 week after the onset of clinical illness. HAV infection produces a self-limited disease that does not result in chronic infection or chronic liver disease.

How is Hepatitis A is transmitted?

Person-to-person transmission through the fecal-oral route (i.e., ingestion of something that has been contaminated with the feces of an infected person) is the primary means of HAV transmission result from close personal contact with an infected household member or sex partner.

Common-source outbreaks and sporadic cases also can occur from exposure to fecally contaminated food or water. Uncooked Hep A contaminated foods have been recognized as a source of outbreaks. Cooked foods also can transmit HAV if the temperature during food preparation is inadequate to kill the virus or if food is contaminated after cooking, as occurs in outbreaks associated with infected food handlers. Waterborne outbreaks of Hep A can happen in under developed and developing countries with poorly maintained sanitation and water supplies.

Who is at increased risk for acquiring HAV infection?

  • Travelers to countries with high or intermediate endemicity of HAV infection
  • Homosexual partners, Users of injection and non-injection illegal drugs
  • Persons with clotting factor disorders
  • Contaminated salads,salad bars, contaminated meat and uncooked sea food

What are the signs and symptoms of HAV infection?

When symptoms are present, they usually occur abruptly and can include the following: Fever,Fatigue, Loss of appetite,NauseaVomitingAbdominal painDark urineClay-colored bowel movementsJoint painJaundice In children aged <6 years, 70% of infections are asymptomatic; if illness does occur, it is typically not accompanied by jaundice. Among older children and adults, infection is typically symptomatic, with jaundice occurring in >70% of patients.p

When symptoms occur, how long do they usually last?

Symptoms usually last less than 2 months, although 10%–15% of symptomatic persons have prolonged or relapsing disease for up to 6 months.

What is the incubation period for Hepatitis A?

The average incubation period for Hepatitis A is 28 days (range: 15–50 days).

How long does HAV survive outside the body? How can the virus be killed?

HAV can live outside the body for months, depending on the environmental conditions. The virus is killed by heating to 185 degrees F (85 degrees C) for one minute. However, the virus can still be spread from cooked food if it is contaminated after cooking.

Can Hepatitis A become chronic?

No. Hepatitis A does not become chronic.

Can persons become reinfected with HAV after recovering from Hepatitis A?

No. IgG antibodies to HAV, which appear early in the course of infection, provide lifelong protection against the disease.

How is HAV infection prevented?

Vaccination with the full, two-dose series of Hepatitis A vaccine is the best way to prevent HAV infection. Hepatitis A vaccine is available persons 12 months of age and older.

Good hygiene — including hand washing or use of hand sanitizer after using the bathroom, changing diapers, and before preparing or eating food — is also integral to Hepatitis A prevention, given that the virus is transmitted through the fecal–oral route.

Travelers to developing and underdeveloped countries strongly recommended to take vaccinations.

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