1. Adult Immunization 2010 Hepatitis A Vaccine Segment This material is in the public domain This information is valid as of May 25, 2010

2. Hepatitis A Fecal-oral transmission Indistinguishable from other types of hepatitis Does not lead to chronic infection Complications related to the acute disease

3. Hepatitis A Vaccines Inactivated whole virus –HAVRIX –VAQTA Single dose with a booster dose 6 to 18 months after the first dose Supplied as a liquid in prefilled syringes and single dose vials

4. Twinrix Hepatitis B (adult dose) and hepatitis A (pediatric dose) 3-dose series at 0, 1, 6 to12 months 4-dose series at 0, 7, 21 to 30 days, booster at 12 months Approved only for adults 18 years of age and older

5. Schedules That Include Both Twinrix and Hepatitis A Vaccine Adult formulation single-antigen hepatitis A vaccine may be used to complete a schedule begun with Twinrix and vice versa Acceptable schedules –2 Twinrix and 1 hepatitis A –1 Twinrix and 2 hepatitis A Maintain spacing recommended for Twinrix –1 month between doses 1 and 2 –5 months between doses 2 and 3

6. Hepatitis A Vaccine Recommendations International travelers Men who have sex with men Injection and noninjection drug users Persons with occupational risk (limited to certain laboratory personnel and animal handlers) Persons with chronic liver disease MMWR 2006;55(RR-7)

7. Hepatitis A Vaccine Recommendations All previously unvaccinated persons who anticipate close personal contact with an international adoptee from a country of high or intermediate endemicity during the first 60 days following arrival of the adoptee in the United States The first dose should be administered as soon as adoption is planned MMWR 2009;58(36):1006-7

8. Hepatitis A Vaccine International Travel The first dose of hepatitis A vaccine should be administered as soon as travel is considered For healthy persons 40 years of age or younger: –1 dose of single-antigen vaccine administered at any time before departure Persons at risk of severe disease from hepatitis A virus planning to travel in 2 weeks or sooner should receive the first dose of vaccine and also can be administered immune globulin MMWR 2007;56(41):1080-4

9. Hepatitis A Postexposure Prophylaxis For healthy persons 12 months through 40 years of age: –single-antigen hepatitis A vaccine should be administered as soon as possible after exposure For persons older than 40 years: –immune globulin is preferred –vaccine can be used if IG cannot be obtained MMWR 2007;56(41):1080-4

10. Hepatitis A Vaccine Contraindications and Precautions Severe allergic reaction to a vaccine component or following a prior dose Moderate or severe acute illness MMWR 2006;55(RR-7)

11. Hepatitis A Vaccine Adverse Reactions Local reactions20%- 50% Systemic reactions (fever, malaise) <10% No serious adverse reactions reported MMWR 2006;55(RR-7)

12. National Center for Immunization and Respiratory Diseases Contact Information Telephone (800) CDC-INFO Email nipinfo@cdc.govnipinfo@cdc.gov Website http://www.cdc.gov/vaccines/ http://www.cdc.gov/vaccines/ Broadcast Updates and Resources Web Page http://www.cdc.gov/vaccines/ed/webcasts.htm