hepatitis A vaccine (Harvix, VAQTA)

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Indications

Limitations:

* should be given with immune globulin to persons travelling within 2 weeks[2]; immune globulin alone no longer recommended[2]

* hepatitis A immune globulin* not necessary before travel to endemic area or post-exposure in healthy person < 40 years[2][11]

Contraindications

Caution:

pregnancy-category C

safety in lactation ?

Dosage

Primary immunization:*

  • Harvix:
  • VAQTA:
    • Children 2-17 years: 25 units (0.5 mL)
    • Adults >= 18 years: 50 units (1 mL)

* 90% effective within 2-4 weeks

Booster:

Injection:

Pharmacokinetics

  • protective antibodies develop in ~100% of health patients within 2-4 weeks[2]
  • elimination: liver

Adverse effects

Notes

More general terms

Additional terms

Component of

References

  1. Kaiser Permanente Northern California Regional Drug Formulary, 1998
  2. 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 2.9 Medical Knowledge Self Assessment Program (MKSAP) 11, 14, 17, 18, 19. American College of Physicians, Philadelphia 1998, 2006, 2015, 2018, 2021.
    Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022
  3. 3.0 3.1 Journal Watch 22(3):25, 2002 Averhoff et al JAMA 286:2968, 2001
  4. 4.0 4.1 Prescriber's Letter 9(7):40 2002
  5. 5.0 5.1 Wasley A, Samandari T, Bell BP. Incidence of hepatitis A in the United States in the era of vaccination. JAMA. 2005 Jul 13;294(2):194-201. PMID: https://www.ncbi.nlm.nih.gov/pubmed/16014593
  6. Prescriber's Letter 13(2): 2006 Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=220203&pb=PRL (subscription needed) http://www.prescribersletter.com
  7. 7.0 7.1 Prescriber's Letter 14(9): 2007 Immunization Update 2007 Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=230923&pb=PRL (subscription needed) http://www.prescribersletter.com
  8. 8.0 8.1 Maglione MA et al Safety of Vaccines Used for Routine Immunization of US Children: A Systematic Review. Pediatrics; published online July 1, 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25086160 <Internet> http://pediatrics.aappublications.org/content/early/2014/06/26/peds.2014-1079.full.pdf+html
    Byington CL Vaccines: Can Transparency Increase Confidence and Reduce Hesitancy? Pediatrics; published online July 1, 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25086161 <Internet> http://pediatrics.aappublications.org/content/early/2014/06/26/peds.2014-1494.full.pdf+html
  9. Doshani M, Weng M, Moore KL, Romero JR, Nelson NP. Recommendations of the Advisory Committee on Immunization Practices for Use of Hepatitis A Vaccine for Persons Experiencing Homelessness. MMWR Morb Mortal Wkly Rep 2019;68:153-156 https://www.cdc.gov/mmwr/volumes/68/wr/mm6806a6.htm
  10. 10.0 10.1 CDC Health Alert. March 25, 2019 Update: Widespread Outbreaks of Hepatitis A among People Who Use Drugs and People Experiencing Homelessness across the United States. https://emergency.cdc.gov/han/han00418.asp
  11. 11.0 11.1 Nelson NP, Link-Gelles R, Hofmeister MG et al Update: Recommendations of the Advisory Committee on Immunization Practices for Use of Hepatitis A Vaccine for Postexposure Prophylaxis and for Preexposure Prophylaxis for International Travel. MMWR Morb Mortal Wkly Rep. 2018 Nov 2;67(43):1216-1220. PMID: https://www.ncbi.nlm.nih.gov/pubmed/30383742 PMCID: PMC6319798 Free PMC article
  12. Department of Veterans Affairs, VA National Formulary