Hepatitis A vaccination

Vaccine

In Germany there are several individual vaccines and combination vaccines that include Hepatitis B:

HAVpur
Composition: 1 vaccine dose (0.5 ml) contains the following: Inactivated hepatitis A viruses that have been bred on cultures of human diploid cells( MRC-5) at least 500 RIA-Units (RIA-Units are in reference standard to the manufacturer). Further additives: Virosomes as adjuvants consisting of the influenza virus (A/Singapore/6/86; H1N1), Haemaglutinin, Phospholipids, Sodium chloride, water

for injection purposes, traces of formaldehyde and heptan, thimerosal traces (from the manufacturing process)

Havrix 1440 Hepatitis-A-Vaccine
Composition: 1 ml (1 dose) contains the following: Hepatitis-A-viruses, inactivated, bred in HDC-cultures ( MRC-5) 1440 antigen units.
Further additives:Aluminiumhydroxide-Gel,  Phenoxyethanol, Polysorbate 20, Formaldehyd,Framycetinsulphate, amino acid mixture, sodium dihydrogen phosphate, potassium monohydrogen phosphate, sodium chloride, potass

ium chloride, water for injection purposes

Havrix 720 pediatric Hepatitis-A-vaccine
Composition: 0.5 ml (1 dose) contains the following: Hepatitis-A-viruses, inactivated, bred in HDC-cultures ( MRC-5) 720 antigen units. Further additives: aluminumhydroxid-Gel,  phenoxyethanol, polysorbat 20, formaldehyde ,Framycetinsulphate, amino acid mixture, sodium dihydrogen phosphate, Potassiummono hydrogenphosphate, sodiumchloride, potassiumchloride, water for injection purposes.

VAQTA®
Composition: 0.5 ml contains: Hepatitis-A-Virus-Protein 25 E. strain CR 326F, cleaned, inactivated (bred on diploid human.  MRC-5-Fibroblast-cell cultures); adsorbed on approx. 0,225 mg aluminium (as Aluminiumhydroxid). Further additives: Aluminumhydroxide, sodiumborat, sodiumchloride, water for injection purposes, traces of formaldehyde,  Neomycin

Twinrix adult Hepatitis-A- and -B-vaccine

Composition: 1 ml (1 dose) contains: Hepatitis-A-Virus 720 ELISA-units inactivated, bred in HDC-cultures (MRC 5), Hepatitis-B-surface antigen 20 μg m genetically engineered in yeast cells. Further additives: aluminiumhydroxide, aluminiumphosphaet, formaldehyde, neomycinsulfat, Phenoxyethanol, Sodiumchloride, water for injection purposes

Twinrix children Hepatitis-A- and -B-vaccine

Composition: 0.5 ml (1 dose) contains the following: Hepatitis-A-Virus 360 ELISA-units inactivated, bred in HDC-cultures (MRC 5), Hepatitis-B-surface antigen 10 μg genetically engineered in yeast cells. Further additives: aluminiumphosphate and aluminiumhydroxide, aminoacids for injection purposes,formaldehyde, neomycinsulfate,  phenoxyethanol, polysorbaet 20, sodiumchloride, residual material of tris and phosphate buffers, water for injection purposes

Immunity

95% of people who are vaccinated the first time develop antibodies. It is recommended to have a second vaccination for longer lasting protection.

Indication for vaccination

The vaccination is presently only recommended for certain types of people, including people who travel in countries with a hepatitis A risk, people who have chronic liver insufficiency, homosexuals, drug addicts, people who work in laboratories and pediatric infection departments.

There is no general recommendation for vaccinations for children because they have a very low risk of contracting the disease. The combination vaccine Twinrix has not been approved in Germany for the first year of life which is why it is not recommended.

Before the vaccination the antibody titre must be determined due to the fact that the course of the disease does not have symptoms in many cases and a vaccination would then be superfluous.

Diverse effects, vaccine complications and vaccine damages of hepatitis A vaccination

The following is a list of side effects which, according to the package insert, can be caused by hepatitis A vaccination:

HAVpur
Side effects: Local reactions (redness, swelling, pain).general reactions (e.g. headache, elevated temperature, malaise). Allergic reactions (rare) include malaise, nausea, anorexia, fever and gastrointestinal problems. Rare: Dizziness, vomiting and allergic reactions such as pruritis and urticaria. In individual cases there has been elevation of liver enzyme values after the vaccination; there have been cases of infection of the central and peripheral nerve system, including rising paralysis, including respiratory paralysis (below the determination limit, e.g.  Guillain-Barré-Syndrome.

Havrix 1440 Hepatitis-A-vaccine
Side effects: Local reactions (redness, swelling, pain).General reactions (e.g. headache, elevated temperature, malaise). Allergic reactions (rare).rare diarrhea, vomiting, slightly elevated liver enzyme values.

Havrix 720 Children Hepatitis-A-vaccine
Side effects: Local reactions (redness, swelling, pain).General reactions (e.g. headache, elevated temperature, malaise). Allergic reactions (are).Rare diarrhea, vomiting, slightly elevated liver enzyme values.

VAQTA®
Side effects: Local reactions (redness, swelling, pain) General reactions (e.g. headache, elevated temperature, malaise). Allergic reactions (rare) Rare: Vomiting, muscle stiffness. Very rare: elevated liver enzymes. Individual cases: Disturbances of the central or periph. Nervous system, including Guillain-Barré-Syndrome a. Thrombocytopeniea.

Twinrix adult Hepatitis-A- and -B-vaccine
Side effects: Local reactions (redness, swelling, pain). General reactions (e.g. headache, elevated temperature, malaise). Allergic reactions (rare).

Twinrix children Hepatitis-A- and -B-vaccine
Side effects: Local reactions (redness, swelling, pain).General reactions (e.g. headache, elevated temperature, malaise). Allergic reactions (rare).

Definition according to package insert: 

Frequent = more than 10%
Occasional = 1-10%
Rare = up to 1%
Very rare = 0.1%
Individual cases = individuals reporting

Due to the fact that hepatitis A vaccination is generally administered together with hepatitis B vaccination, the side effects of hepatitis B vaccination should also be considered.