Hepatitis A immunization for children

Hepatitis A (infectious hepatitis) is a viral liver infection. The hepatitis A virus is found in the stool of infected persons. It spreads primarily through fecal-oral contact. It easily spreads through contaminated food or water, and through sexual contact. Rarely, hepatitis A spreads through blood or blood products. Severity varies considerably from person to person. Some people have few or no symptoms, while others may be very ill for several weeks. Adults are usually more ill than children with hepatitis A, but most fully recover. Rarely, hepatitis A may lead to liver failure.

At least one-third of all reported cases of hepatitis A occur in children under age 15 years. However, children with hepatitis A often have no symptoms or only mild symptoms that may not be diagnosed correctly. Because these children can spread the infection, the hepatitis A vaccine now is recommended for all children who live in communities where the rate of hepatitis A is higher than average. Consult your local public health department or ask your doctor to determine if you live in one of these communities.

The hepatitis A vaccine is an inactivated vaccine, which means that it contains a dead form of the hepatitis A virus.


Recommendations/dose
All children ages 12 months to 23 months now are routinely vaccinated for hepatitis A. Vaccination continues to be recommended for children who are at high risk for contracting the disease or developing complications from the illness. This includes adolescent males who have sex with other males, and children and adolescents who:
live in or travel to countries where hepatitis A is prevalent
use illegal drugs
have blood clotting disorders
have an occupational risk (work with hepatitis A infected primates or in hepatitis A research)
have chronic liver disease, including hepatitis C
Two doses routinely are given, the first between ages 12 months and 23 months and the second at least six months after the first. Older children who are at risk of contracting hepatitis A also receive two doses, with the second dose given six to 12 months after the first dose.


Effectiveness/booster
Immunity begins within one month after the first dose. The vaccine is up to 100 percent effective in preventing the disease after two doses. Length of protection is uncertain, but may exceed 20 years. A booster isn't currently recommended.

Side effects
Side effects typically are minor. The most common include pain, soreness, redness or swelling at the injection site; headache; and loss of appetite or feeding problems. These symptoms usually begin three to five days after the shot and last for one to two days. Very rarely, an allergic reaction may occur.

Who should wait to get the vaccine?
Your child's doctor may postpone this vaccine if your child has a moderate to severe acute illness.

Who shouldn't get the vaccine?
Your child shouldn't get the vaccine if he or she has had a serious reaction or severe allergy to a prior hepatitis A vaccination or any of its components.