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Can a patient receive the first dose of hepatitis A vaccine from one manufacturer and the second (last) dose from another manufacturer?
Yes. Although studies have not been done to look at this issue, there is no reason to believe that this would be a problem.
What should be done if the second (last) dose of hepatitis A vaccine is delayed?
The second dose should be administered as soon as possible. There is no need to repeat the first dose.
Can other vaccines be given at the same time that hepatitis A vaccine is given?
Yes. Hepatitis B, diphtheria, poliovirus (oral and inactivated), tetanus, oral typhoid, cholera, Japanese encephalitis, rabies, yellow fever vaccine or immune globulin can be given at the same time that hepatitis A vaccine is given, but at a different injection site.
Is hepatitis A vaccine safe?
Yes, hepatitis A vaccine has an excellent safety profile. No serious adverse events have been attributed definitively to hepatitis A vaccine. Soreness at the injection site is the most frequently reported side effect.
Any adverse event suspected to be associated with hepatitis A vaccination should be reported to the Vaccine Adverse Events Reporting System (VAERS). VAERS forms can be obtained by calling 1-800-822-7967.
How are hepatitis A vaccines made?
There is no live virus in hepatitis A vaccines. The virus is inactivated during production of the vaccines, similar to Salk-type inactivated polio vaccine.
How long does hepatitis A vaccine protect you?
Although data on long-term protection are limited, estimates based on modeling techniques suggest that protection will last for at least 20 years.
When are persons protected after receiving hepatitis A vaccine?
Protection against hepatitis A begins four weeks after the first dose of hepatitis A vaccine.
Can hepatitis A vaccine be given after exposure to hepatitis A virus?
No, hepatitis A vaccine is not licensed for use after exposure to hepatitis A virus. In this situation, immune globulin should be used.
Should pre-vaccination testing be done?
Pre-vaccination testing is done only in specific instances to control cost (e.g., persons who were likely to have had hepatitis A in the past). This includes persons who were born in countries with high levels of hepatitis A virus infection, elderly persons, and persons who have clotting factor disorders and may have received factor concentrates in the past.
Should post-vaccination testing be done?
No.
Can hepatitis A vaccine be given during pregnancy or lactation?
We don't know for sure, but because vaccine is produced from inactivated hepatitis A virus, the theoretical risk to the developing fetus is expected to be low. The risk associated with vaccination, however, should be weighed against the risk for hepatitis A in women who may be at high risk for exposure to hepatitis A virus.
Can hepatitis A vaccine be given to immunocompromised persons? (e.g., persons on hemodialysis or persons with AIDS)
Yes.
What is Twinrix®?
It is a combined hepatitis A and hepatitis B vaccine for use in persons aged 18 years and older. Primary vaccination consists of three doses, given on a 0-, 1-, and 6-month schedule, the same schedule as that used for hepatitis B vaccine alone.
Immune Globulin
What is immune globulin?
Immune globulin is a preparation of antibodies that can be given before exposure for short-term protection against hepatitis A and for persons who have already been exposed to hepatitis A virus. Immune globulin must be given within 2 weeks after exposure to hepatitis A virus for maximum protection.
Is immune globulin safe?
Yes. No instance of transmission of HIV (the virus that causes AIDS) or other viruses has been observed with the use of immune globulin administered by the intramuscular route. Immune globulin can be administered during pregnancy and breast-feeding.
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