Hepatitis A Vaccine

I am writing from Israel. They are now offering to immunize infants starting at 3 months old with Hepatitis A vaccines. Are there any side effects? Has this vaccine been proven reliable? What are the risks? What if I don't give it? My son is 17 months - should he also get vaccinated?

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Robert Steele

Robert W. Steele, MD, is a board certified pediatrician at St. John's Regional Health Center in Springfield, MO. He graduated from medical... Read more

Hepatitis A is a viral infection for which a vaccine has recently been marketed. In the United States, there are two companies that currently have FDA approval for immunization to those at high risk for developing Hepatitis A or those who could become severely ill if they were to acquire the infection. The infection is acquired primarily through person-to-person contact or by ingesting contaminated food or water.

In the U.S., which children should receive the vaccine?

  1. Travelers - Persons who plan to travel to developing countries have a much higher risk of getting this infection. Countries in which Hepatitis A vaccination is recommended prior to visiting can be found at http://www.cdc.gov/travel/index.html.
  2. Children with Chronic Liver Disease - These children who already have medical problems involving the liver are at a much higher risk from dying of Hepatitis A if they get it.
  3. Those with hemophilia - In the past, some children have who required transfusions with clotting factor have gotten Hepatitis A from these transfusions. There is currently very good surveillance of these clotting factor preparations; however, it is still recommended that children with hemophilia receive the vaccine.
  4. Adolescent males who have sex with other males.
  5. Adolescents who use IV drugs.
  6. Children who live in communities that have high rates of Hepatitis A and periodic outbreaks - This information can be found at the local health department.

Is the vaccine effective?

The vaccine itself is an inactivated one. In other words, you cannot get the illness from getting the vaccine. In addition, it is a highly effective vaccine among children who are vaccinated after the age of 1. There currently is not a whole lot of research looking at those who have been vaccinated prior to one year of age. However, the studies that have been done in those under 12 months have also shown it to be very highly effective in creating immunity to the virus.

Does the vaccine give immunity for life?

Unfortunately, how long this immunity lasts or if booster shots will be required is currently unknown. The vaccines currently available in the U.S. have only been available for about 6 years. It appears the immunity is still strong for these six years, and some experimental evidence exists that it could last for more than twenty.

Are there side effects?

In over the 49,000 children in clinical studies to whom this vaccine has been given, there have been no reported serious side effects. The most common side-effects reported are soreness and swelling at the injection site and headache. The side-effects have been likened to the those of the Hepatitis B vaccine which is currently recommended for all children.

Which children should NOT receive the vaccine?

Vaccines contain other materials which help them be more effective and preserve them. Any children who have a history of being allergic to these should not be immunized with the Hepatitis A vaccine.

Why target children for immunization against Hepatitis A?

Hepatitis A is easily transmitted through children because they often have no symptoms when they get infected. It is usually only when an adult gets the infection that others become aware that an outbreak has occurred. This is due to the fact that adults who get Hepatitis A generally become quite ill. On the other hand, the younger the child, the less likely he is to have evidence of infection. So, by the time the child has successfully fought off the infection, he has probably infected several other people. Therefore, the only way to effectively eradicate this virus is to successfully immunize all children against this virus.

The current recommendation in the U.S. does not call for routine immunization of all children because it is not a wide-spread problem in this country. However, in certain countries, a large portion of the population does have the virus. If you are travelling to a part of the world that includes those that have a high number of people with the disease, it would be wise to have your child immunized against Hepatitis A. However, this risk may vary depending upon where you specifically live in Israel and your family's travel plans.

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