About Vaccination - Hepatitis A

When I take Willow to the Pediatrician and she gets any kind of shots, the doctor gives us a pamphlet with information on the shots. So, since everyone is all up in arms about the links between vaccinations and things like autism, I thought I'd take an in-depth look at the vaccinations. Next in line is the Hepatitis A Vaccination.

The United States' Centers for Disease Control and Prevention (CDC) Vaccinations and Immunizations section has a recommended immunization schedule that you can download. They also have a lot of great information for each and every vaccination so this is where I will start in my search for information. Here is their pamphlet on the Hepatitis A Vaccination.

The Hepatitis A Vaccination is given in two doses. The first dose can be administered when your child is between 12 and 15 months of age and the second 6 months after. NOTE: Persons who get the vaccine less than one month before traveling can also get a shot called immune globulin (IG). IG gives immediate, temporary protection.

First, what exactly is Hepatitis A?


Hepatitis A, (formerly known as infectious hepatitis), is an acute infectious disease of the liver caused by Hepatitis A virus, which is most commonly transmitted by the fecal-oral route via contaminated food or drinking water. Every year, approximately 10 million people worldwide are infected with the virus. The time between infection and the appearance of the symptoms, (the incubation period), is between two and six weeks and the average incubation period is 28 days.

Hepatitis A does not have a chronic stage and does not cause permanent liver damage. Following infection, the immune system makes antibodies against the hepatitis A virus that confer immunity against future infection. The disease can be prevented by vaccination and hepatitis A vaccine has been proved effective in controlling outbreaks worldwide.

Hepatitis A is contagious. The virus spreads by the fecal-oral route (ingesting feces) and infections often occur in conditions of poor sanitation and overcrowding. Hepatitis A can be transmitted by the parenteral route (through the skin or mucus) but very rarely by blood and blood products. Food-borne outbreaks are not uncommon, and ingestion of shellfish cultivated in polluted water is associated with a high risk of infection.

Why get vaccinated? Infection with the hepatitis A virus (HAV) can result in symptoms that include abrupt onset with fever, malaise, anorexia, nausea and abdominal discomfort, followed by jaundice within a few days. The disease varies from a mild illness that lasts 1-2 weeks to a severe, disabling disease that lasts for months. Prolonged, relapsing hepatitis for up to one year occurs in 15% of adult cases, but chronic infection is not known to occur. The case fatality rate is usually low, but adults over 50 and persons with chronic liver disease are at elevated risk of fulminant hepatitis A and death.

How about a brief History of Hepatitis A? The first descriptions of hepatitis (epidemic jaundice) are generally attributed to Hippocrates. Outbreaks of jaundice, probably hepatitis A, were reported in the 17th and 18th centuries, particularly in association with military campaigns. Hepatitis A (formerly called infectious hepatitis) was first differentiated epidemiologically from hepatitis B, which has a long incubation period, in the 1940s. Development of serologic tests allowed definitive diagnosis of hepatitis B. In the 1970s, identification of the virus, and development of serologic tests helped differentiate hepatitis A from other types of non-B hepatitis.

Until 2004, hepatitis A was the most frequently reported type of hepatitis in the United States. In the prevaccine era, the primary methods used for preventing hepatitis A were hygienic measures and passive protection with immune globulin (IG). Hepatitis A vaccines were licensed in 1995 and 1996. These vaccines provide long-term protection against hepatitis A virus (HAV) infection. The similarities between the epidemiology of hepatitis A and poliomyelitis suggest that widespread vaccination of appropriate susceptible populations can substantially lower disease incidence, eliminate virus transmission, and ultimately, eliminate HAV infection.

Now, on to the vaccination itself.

A vaccine, like any medicine, is capable of causing serious problems, such as severe allergic reactions. The risk of Hepatitis A vaccine causing serious harm, or death, is extremely small.

Getting the Hepatitis A vaccine is much safer than getting Hepatitis A disease. Most people who get Hepatitis A vaccine do not have any problems with it.

Mild Problems

• soreness where the shot was given (about 1 out of 2 adults, and up to 1 out of 6 children)


• headache (about 1 out of 6 adults and 1 out of 25 children)


• loss of appetite (about 1 out of 12 children)


• tiredness (about 1 out of 14 adults)

Severe Problems

• serious allergic reaction, within a few minutes to a few hours of the shot (very rare)

Some people should not get the Hepatitis A vaccine or should wait.

• Anyone who has ever had a severe (life-threatening) allergic reaction to a previous dose of hepatitis A vaccine should not get another dose.


• Anyone who has a severe (life threatening) allergy to any vaccine component should not get the vaccine. Tell your doctor if you have any severe allergies. All hepatitis A vaccines contain alum and some hepatitis A vaccines contain 2-phenoxyethanol.


• Anyone who is moderately or severely ill at the time the shot is scheduled should probably wait until they recover. Ask your doctor or nurse. People with a mild illness can usually get the vaccine.


• Tell your doctor if you are pregnant. The safety of hepatitis A vaccine for pregnant women has not been determined. But there is no evidence that it is harmful to either pregnant women or their unborn babies. The risk, if any, is thought to be very low.

In keeping with tradition, I looked for evidence of this vaccination causing any kind of neurological disorder and found none.

I found an awesome website that lists the package inserts and ingredients for all available vaccinations (e.g. provided by MERK or GlaxoSmithKline). It's called the World Association for Vaccine Education. You can find their page on the Hepatitis A Vaccine here.


More Information:

• Guide to Contraindications to Vaccination (a Contraindication is a condition or factor that increases the risks involved in using a particular drug, carrying out a medical procedure, or engaging in a particular activity.)


• Division of Environmental Health and Communicable Disease Prevention pamphlet on Hepatitis A


• VaccineInformation.org - The Immunization Action Coalition works to increase immunization rates and prevent disease by creating and distributing educational materials for health professionals and the public that enhance the delivery of safe and effective immunization services. The Coalition also facilitates communication about the safety, efficacy, and use of vaccines within the broad immunization community of patients, parents, health care organizations, and government health agencies.


• Facts for Parents About Vaccine Safety from the AAP


• Adult Immunization Schedule

And since there are those people that are concerned about links of vaccinations to neurological disorders and the like I thought I'd include some of their links as well:

Generation Rescue is an international movement of scientists, physicians and parent-volunteers researching the causes and treatments for autism and mentoring thousands of families in recovering their children from autism.

The Thinktwice Global Vaccine Institute was established in 1996 to provide parents and other concerned people with educational resources enabling them to make more informed vaccine decisions. Thinktwice encourages an uncensored exchange of vaccine information, and supports every family's right to accept or reject vaccines. Thinktwice does not have a page on Hepatitis A.


I asked my pediatrician if she had a lot of parents who were choosing to NOT vaccinate their children. She said she could count on one hand the total number and that she, of course, recommends AGAINST not vaccinating your children.

Previously:
Hepatitis B Vaccination Information
Rotavirus Vaccination Information
Diphtheria Vaccination Information
Tetanus Vaccination Information
Pertussis (Whooping Cough) Vaccination
Haemophilus influenzae type b (Hib) Vaccination Information
Pneumococcal Conjugate Vaccination Information
Polio Vaccination Information
Influenza (Flu) Vaccination Information
Measles Vaccination Information
Mumps Vaccination Information
Rubella Vaccination Information
Varicilla (Chickenpox) Vaccination Information


Next week: Last, but certainly not least, we will talk about the Meningococcal Vaccination