Vaccination

Hepatitis A

This disease occurs worldwide. The intermediate and high endemicity regions are Africa, Asia (except Japan), Latin America and Latin and East Europe. Both vaccine and immune globulin may be prescribed. Hepatitis A vaccine is recommended for susceptible persons, above the age of 1-2 years, who travel repeatedly or for long periods to endemic regions or poor hygiene countries. The immune globulin is recommended for susceptible travelers less than two years of age and for persons of all ages that desires a short-term protection (3-6 months). The immune globulin is effective immediately after its administration.

Several inactivated hepatitis A vaccines (monovalent) are manufactured. Different vaccines may have different immunization schedules and doses. There are also combined vaccines (bivalent) that may be preferable, according to the risk (destination and personal):  hepatitis A and B vaccine, and hepatitis A and typhoid vaccine. Generally, primary vaccination consider one dose, and boosters may be advisable every ten years.

Pregnancy is not a contraindication for both immune globulin and vaccine. The risk of receiving these immune biologicals should be weighted against the risk of hepatitis A in women who might be at high risk of exposure to the virus.

A combined vaccine against hepatitis A and B may be considered for travellers potentially exposed to both virus. For this combined inactivated vaccine there are three possible schedules:

- Regular: three doses given at days 0-30-180;

- Rapid: three doses given at days 0-30-60, with an aditional dose at 12 months;  and

- Extra-rapid: three doses given at days 0-7-21, with a booster dose at 12 months.

Fernando Costa Silva, 1999 (last update: 2009)