HEPATITIS A VACCINE
| HEPATITIS A VACCINE (hep'a-ti-tis) Havrix, Vaqta Classifications: vaccine; Therapeutic: vaccine Prototype: Hepatitis B vaccine Pregnancy Category: C |
Availability
720 EIU/0.5 mL, 1440 EIU/1 mL (Havrix); 25 U/0.5 mL, 50 U/1 mL (Vaqta)
Action
Anti-hepatitis A virus antibody titers following administration of hepatitis A vaccine (inactivated) are comparable to those observed after natural hepatitis A virus infection.
Therapeutic Effect
Antibody levels are 50- to 300-fold higher with inactivated hepatitis A vaccine than with passive immunity with human immune globulin.
Uses
Active immunization against hepatitis A.
Contraindications
Hypersensitivity to any component in vaccine, pregnancy (category C), children <12 mo.
Cautious Use
Severe cardiac disease; coagulopathy; concurrent anticoagulant therapy; vitamin K deficiency; lactation.
Route & Dosage
| Hepatitis A Immunization Adult: IM 1 mL in deltoid muscle; booster dose (1 mL) at 6–12 mo after primary dose Child (1–18 y): IM 2 doses of 0.5 mL in deltoid muscle given 1 mo apart; booster dose (0.5 mL) at 6–12 mo after primary doses |
Administration
Intramuscular- Give only in deltoid for adults and children older than 2 y. DO NOT give IV, SC, or intradermally.
- Use vaccine as packaged without dilution.
- Shake vial and syringe well before withdrawal and injection, respectively. Vaccine should be an opaque white suspension; discard if it looks otherwise.
- Store at 2°–8° C (36°–47° F). Discard vaccine if it has been frozen.
Adverse Effects (≥1%)
CNS: Headache, fatigue, fever, malaise, somnolence vertigo, insomnia, photophobia, convulsions, neuropathy, paresthesia. GI: Anorexia, nausea, abdominal pain, diarrhea, dysgeusia, vomiting. Skin: Pruritus, rash, urticaria, erythema multiforme, hyperhidrosis, angioedema (rare). Other: Soreness at injection site, pain, swelling, redness at injection site, pharyngitis, lymphadenopathy.Interactions
Drug: No clinically significant interactions established.Pharmacokinetics
Onset: 3 wk. Duration: 1–3 y with single dose, 5–10 y with booster.Nursing Implications
Assessment & Drug Effects
- Do not administer during a febrile illness.
- Assess for S&S of anaphylaxis and have epinephrine available.
Patient & Family Education
- Note: Injection site soreness is common; most adverse reactions are mild and usually last less than 24 h.
- Get booster injection within 6–12 mo if risk of exposure is still present.
Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; 
Canadian drug name; 
Prototype drug