Available vaccines: Hepatitis A: AVRIX, VAQTA, Hepatitis B: ENGERIX-B, RECOMBIVAX HB, HEPLISAV-B, Combination: TWINRIX, PEDIARIX (combination hepatitis B, diphtheria, tetanus, acellular pertussis, inactivated polio)
Hepatitis A
Hepatitis A is a virus that is transmitted person to person through the fecal-oral route or by consuming contaminated food or water. Unlike hepatitis C, hepatitis A does not cause chronic infection and is a self-limiting disease that typically resolves in 2 months. Those infected with hepatitis A will experience symptoms of fatigue, low appetite, stomach pain, nausea, and jaundice (present in over 70% of older children and adults). In children, most infections are asymptomatic.Hepatitis A has an incubation period of 28 days prior to development of symptoms.
Individuals who are at increased risk of hepatitis A include those who travel to countries with a high or intermediate endemicity of hepatitis A infections, men who have sex with men, injection and noninjection drug users, individuals with clotting-factor disorders, and those who work with primates.
Hepatitis A Vaccine
Incidence of hepatitis A in the United States declined more than 95% since the introduction of the hepatitis A vaccine. Since it is an inactivated vaccine, individuals with compromised immune systems can receive the vaccine. Antibodies for hepatitis A have been found in patients 20 years after inoculation.Hepatitis B
Hepatitis B is a contagious liver disease that infects 850,000 to 2.2 million individuals in the United States, and there are 240 million people infected globally, contributing to approximately 760,000 deaths each year.Hepatitis B virus infections can be acute and resolve on their own, or infections can develop into a chronic liver disease. The younger a person is when diagnosed with hepatitis B, the greater the chance that it will become a chronic infection. While many newly infected individuals may be asymptomatic, initial signs and symptoms of an infection include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, myalgia, and jaundice. Chronic hepatitis B can result in an elevated alanine transaminase (ALT)/aspartate transaminase (AST), cirrhosis, or even hepatocellular carcinoma.
Hepatitis B is transmitted via puncture wounds, mucosal contact with infectious blood or bodily fluids (including sexual intercourse with an infected partner), injection drug use, birth from an infected mother, and sharing items like razors or toothbrushes. It is not spread through food and water like hepatitis A, and it is not contained in respiratory droplets. Individuals can remain asymptomatic for up to 90 days, and the virus can survive for approximately 7 days outside of the body.
Those at increased risk of hepatitis B infections include infants born to infected mothers, men who have sex with men, injection drug users, healthcare and public safety workers at risk for occupational exposure to blood, and those undergoing hemodialysis.
Hepatitis B Vaccine
Antibodies have been found in individuals 30 years after being vaccinated with hepatitis B vaccine. Booster shots are not routinely recommended; however, hemodialysis patients and individuals who are immunocompromised are recommended to receive a booster if their anti-HB antigens fall to <10 mIU/mL.Who Should Get the Vaccine?
ACIP recommends the hepatitis A vaccine to all children at age 1 year, people who are at increased risk for infection or increased risk for complications, those traveling to countries that have a high or intermediate endemicity of hepatitis A, individuals who have occupational risk for infection, and anyone who wishes to have protection.Hepatitis B vaccine is recommended for all infants (starting at birth), any child and adolescent under than age 19 that have not previously received the vaccine, sexually active people with a sex partner who has hepatitis B or if there are multiple sex partners, men who have sex with men, people who share needles or other drug injection equipment, healthcare and public safety workers at risk of exposure to blood and other bodily fluids, people with end-stage renal disease or undergoing dialysis, residents and staff of facilities for developmentally disabled persons, people with chronic liver disease, those who are immunocompromised, and people who intend to travel to regions with moderate or high rates of hepatitis B.
Of note, the following occupations do not need routine vaccination against hepatitis A in the United States: food service workers, sewage workers, healthcare workers, and childcare center staff. However, the hepatitis B vaccine is recommended in individuals who work in healthcare settings such as sexually transmitted disease treatment facilities, HIV testing and treatment facilities, drug-abuse treatment/prevention service sites, correctional facilities, healthcare settings specifically servicing men who have sex with men, hemodialysis facilities, and institutions and nonresidential day-care facilities for developmentally disabled persons.
Who Should Not Get the Vaccine?
Anyone who has had a serious allergic reaction to the vaccine or any component of the vaccine should not receive the vaccine.Side Effects
Injection-site reaction is the most common adverse effect of receiving the hepatitis A and B vaccines. It should also not be administered to anyone who is allergic to yeast since yeast is used to make the vaccine.Insurance Coverage
Medicare part B will cover the hepatitis B shot if an individual is considered high or medium risk for hepatitis; contact the specific insurance provider for more information.Medicare part D plans should cover hepatitis A vaccine; contact the specific insurance provider for more information.
Most private health insurances cover the vaccines; check with your provider for information.
The Vaccines for Children Program may be able to help if an individual does not have health insurance coverage for their child or if their insurance does not cover vaccines.
