What to know
- The Advisory Committee on Immunization Practices (ACIP) recommends routine vaccination for children ages 12–23 months and catch-up vaccination for children ages 2–18 years who have not previously received hepatitis A vaccine.
- ACIP also recommends hepatitis A vaccination for unvaccinated adults who are at increased risk for infection or increased risk for severe disease from infection.
- Hepatitis A vaccine series are typically administered over the course of 6 months.
- Hepatitis A vaccines are safe and highly effective.
Who should be vaccinated
CDC recommends that the following groups be vaccinated against hepatitis A:
Children
- All children ages 12-23 months.
- Unvaccinated children and adolescents age 2-18 years.
People at increased risk for hepatitis A virus (HAV) infection
- International travelers.
- Men who have sex with men.
- People who use or inject drugs (all those who use illegal drugs).
- People with occupational risk for exposure.
- People who anticipate close personal contact with an international adoptee.
- People experiencing homelessness.
People at increased risk for severe disease from HAV infection
- People with chronic liver disease.
- People with human immunodeficiency virus (HIV) infection.
Other people recommended for vaccination
- Pregnant people at risk for HAV infection or severe outcome from HAV infection.
- Any person who requests vaccination.
- People who are unvaccinated and exposed to HAV within the past 2 weeks.
Vaccination during outbreaks
- Unvaccinated people in outbreak settings who are at risk for HAV infection or at risk for severe disease from HAV infection.
For the general public
Composition and dosage
The United States Food and Drug Administration (FDA) has licensed two single-antigen hepatitis A vaccines (Havrix and Vaqta) and one combination vaccine for protection against both hepatitis A and hepatitis B (Twinrix) for use in the US. All three are inactivated vaccines and contain an aluminum adjuvant.
Havrix
There are two formulations for Havrix. People 12 months–18 years should receive two doses of HAV vaccine. People 19 and older should also receive two doses. See package insert for detailed dosage instructions.
Vaqta
Vaqta is also licensed in two formulations. People 12 months–18 years should receive two doses of HAV antigen. People 19 and older should receive two doses as well. See package insert for detailed dosage instructions.
Twinrix
Twinrix is licensed for adults 18 and older and contains HAV antigen and recombinant hepatitis B virus (HBV) surface antigen protein. Primary vaccination with Twinrix involves three doses administered over a 6-month schedule.
Twinrix may be administered on an accelerated schedule before travel or any other potential exposure. In this case, the three doses would be given over a 30-day schedule, followed by a booster dose at 12 months that provides long-term protection.
Vaccine effectiveness
Hepatitis A vaccines are highly effective in preventing HAV infection. The immunoglobulin G (IgG) anti-HAV produced after vaccination confers long-term immunity. However, the exact duration of protection is unknown. In studies of people who received a complete vaccine series, anti-HAV has been shown to persist for at least 20 years.
Safety and precautions
Scientific evidence overwhelmingly supports the safety of hepatitis A vaccines.
As a precaution, clinicians should ask the person getting the vaccine if they've previously experienced:
- An allergic reaction after a previous dose of, or any component of, hepatitis A vaccine.
- An allergic reaction to neomycin or yeast (contraindication for Twinrix).
People who are moderately or severely ill should wait until they recover before getting hepatitis A vaccine. However, administering the vaccine to people with minor illnesses, such as a cold, is fine. Learn more about contraindications and precautions.
Groups who do not need routine vaccination
The following groups are at low risk and do not need routine vaccination against hepatitis A:
- People with clotting-factor disorders.
- Food handlers.
- Workers exposed to sewage.
- Health care personnel.
- Childcare center staff.
For more information, see the most recent ACIP guidelines for the prevention of hepatitis A.
Reporting adverse events
The most frequently reported adverse events associated with hepatitis A vaccination are fever, injection site reactions, and rash. Any adverse event suspected to be associated with hepatitis A vaccination should be reported through the Vaccine Adverse Event Reporting System (VAERS).
VAERS is an early warning system, co-managed by CDC and the FDA, that monitors potential vaccine safety problems. Clinicians and vaccine manufacturers are required by law to report certain adverse events following vaccination to VAERS. Patients and caregivers can also submit reports.
Administration
Clinicians should administer the vaccine intramuscularly into the anterolateral aspect of the thigh or the deltoid muscle of the upper arm, depending on the person’s age. When administering multiple vaccines, clinicians should use different anatomic sites (e.g., separate limbs).
Concurrent administration of other vaccines
Clinicians can administer hepatitis A vaccine concurrently with other vaccines to children and adults. There is no evidence that coadministration reduces the vaccine response or effectiveness.
Vaccination schedules
Clinicians should administer the single-dose hepatitis A vaccine as two shots over 6 months and the combination vaccine as three shots over 6 months. For detailed information on hepatitis A vaccine schedules, see Immunization Schedules for Children or Immunization Schedules for Adults.
Vaccine Information Statement
Vaccine Information Statements (VISs) are information sheets CDC produces to explain both the benefits and risks of a vaccine. View the VIS for hepatitis A vaccine.