Hepatitis A Vaccine

Vaccine

Expand All

Hepatitis A is an infection of the liver caused by the hepatitis A virus. It is generally mild in children, but the severity of the disease tends to increase with age.

There are three types of hepatitis A vaccine; a vaccine for hepatitis A only, a combination vaccine to protect against hepatitis A and hepatitis B, and a combination vaccine to protect against hepatitis A and typhoid.

Two doses of the hepatitis A vaccine, or the hepatitis A and typhoid combination vaccine are needed for long-term protection, with the second dose given 6 to 12 months after the first dose.

The standard hepatitis A and hepatitis B combination vaccines require two or three doses, depending upon which vaccine is offered.

In some countries, only one dose of the hepatitis A vaccine is given – this is informed by multiple studies that looked at the long-term protection offered by a single dose of the vaccine. See the more information section below.

 

Hepatitis A vaccines are not part of the routine UK vaccine schedule because the risk of getting infected is low. You only need to get a vaccine if you are at high risk of catching or getting seriously ill from hepatitis A.

In some countries, which have experienced infection outbreaks, the vaccine is given to all children.

Those at high risk include:

  • people travelling to a country where hepatitis A is common
  • men who have sex with men
  • people who have been in close physical contact with someone with hepatitis A
  • people with long-term liver disease
  • people who inject drugs
  • people with a blood clotting disorder, such as some people with haemophilia
  • people whose job puts them at risk of infection – for example, a healthcare worker or a sewage worker.

Speak to your GP, or sexual health clinic if you think you need a hepatitis A vaccine.

If your job puts you at risk, your employer should organise your vaccination.

If your vaccination is because you plan to travel to a high-risk country, then you may need to visit a private travel clinic to receive the vaccine. Ideally, the vaccine should be given two weeks before departure.

 

Side effects vary between the different types of hepatitis A vaccine, but can include the following:

 

Very common (affecting more than 1 in 10 people at each dose):

  • pain at the injection site
  • redness and hardness at the injection site
  • headache
  • feeling tired, irritable, weak or generally unwell
  • loss of appetite or feeling sick
  • upset stomach or diarrhoea

Common (affecting up to 1 in 10 people at each dose):

  • a slightly raised temperature (fever)
  • swelling or a small lump at the injection site
  • itchy skin
  • aching muscles
  • feeling drowsy

Uncommon (affecting up to 1 in 100 people at each dose):

  • feeling dizzy
  • stomach pain or being sick

For rarer side effects (affecting fewer than 1 in 1000 people), ask to see the Patient Information Leaflet for the vaccine you are offered.

As with any vaccine, medicine or food, there is a very small chance of a severe allergic reaction (anaphylaxis). Anaphylaxis is different from less severe allergic reactions because it causes life-threatening breathing and/or circulation problems. It is always extremely serious but can be treated with adrenaline. Healthcare workers who give vaccines know how to do this.

In the UK between 1997 and 2003 there were a total of 130 reports of anaphylaxis following ALL immunisations.  During these six years, around 117 million doses of vaccines were given in the UK. This means that the overall rate of anaphylaxis is around 1 in 900,000.

If you are concerned about any reactions that occur after vaccination, consult your doctor. In the UK you can report suspected vaccine side effects to the Medicines and Healthcare products Regulatory Agency (MHRA) through the Yellow Card Scheme. You can also contact the MHRA to ask for data on Yellow Card reports for individual vaccines. See more information on the Yellow Card scheme and monitoring of vaccine safety.

 

There are several different makes of hepatitis A vaccine used in the UK. For full information on ingredients, ask for the Patient Information Leaflet for the vaccine you are offered, or look the brand name up on the electronic Medicines Compendium (eMC) 

Apart from the active ingredients, the antigens, all hepatitis A vaccines used in the UK contain very small amounts of this added ingredient:

  • aluminium salts, which strengthens and lengthens the immune response to the vaccine

Hepatitis A vaccines may also contain traces of these products used during the manufacturing process:

  • neomycin, an antibiotic used to stop bacteria from growing and contaminating the vaccine
  • common salt (sodium chloride) and other harmless sodium and potassium salts used as acidity regulators
  • a trace of formaldehyde, used to inactivate the viruses for the vaccine

Growing the active ingredients for the vaccines:

  • the hepatitis A virus strain used to make the vaccines is grown in the laboratory using human cell lines
  • the combined hepatitis A and B vaccines may contain traces of yeast proteins. These come from the yeast used to grow the hepatitis B proteins for the vaccine. A tiny quantity of yeast protein may remain in the vaccine, but there is no evidence that this can cause allergic reactions. The hepatitis B proteins are grown in yeast cells using recombinant DNA technology.

 

People who may be pregnant

There is no evidence of risk from vaccinating pregnant women or those who are breastfeeding with inactivated viral or bacterial vaccines. Therefore, pregnant people can take the vaccine.

People who are immunosuppressed

Individuals with immunosuppression and HIV infection can be given hepatitis A-containing vaccines, however, it may be less effective. Extra doses of the vaccine may be required to increase immunity.

One dose recommendation

In some countries, a single dose of the hepatitis A vaccine is given, either as part of the immunisation schedule, after potential exposure to the virus, or during outbreaks.

A 2012 review of studies that looked at long-term protection of a single dose of the inactivated hepatitis A vaccine found that antibodies that protect against the hepatitis A virus can persist for almost 11 years, and that these can increase with booster doses.

The impact of single-dose hepatitis A inactivated vaccine programmes has been increasingly demonstrated in diverse settings with cases of hepatitis A decreasing by 80–99% in all age groups.

Hepatitis A vaccines are also documented to work well in people who had already been exposed to the hepatitis A virus. In Israel, an outbreak of the virus in a lower socioeconomic community (lower levels of income, education, employment etc) was completely interrupted within weeks by administering a single dose of the inactivated hepatitis A vaccine to more than 90% of the children in the community.

Read the position paper from the World Health Organization for more information.

 

Page last updated Friday, August 18, 2023