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Hepatitis A vaccination

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VOL: 101, ISSUE: 23, PAGE NO: 27

Generic and proprietary names

 

Generic and proprietary names
- Avaxim.

 

 

- Epaxal.

 

 

- Havrix Monodose.

 

 

- Vaqta Paediatric.

 

 

- There are also combined hepatitis A and B vaccines and combined hepatitis A and typhoid vaccines.

 

 

Action
- The vaccine contains inactivated hepatitis A vaccine virus surface antigen and works by provoking the immune system.

 

 

- Duration of immunity is not known but a booster 6-12 months after the primary injection is thought to be sufficient to maintain immunity for 10 years.

 

 

Classification
- Vaccines and antisera.

 

 

Indications
Active immunisation against hepatitis A. Immunisation is recommended for:

 

 

- Laboratory workers who come into direct contact with the virus;

 

 

- People with haemophilia - transmission of hepatitis A has been associated with Factor VIII and Factor IX concentrates;

 

 

- People with haemophilia who have liver disease;

 

 

- People with haemophilia who have been infected with hepatitis B or hepatitis C;

 

 

- Those travelling to areas of high or moderate infection risk, particularly if sanitation and food hygiene are poor;

 

 

- Those whose sexual behaviour puts them at risk.

 

 

Immunisation should be considered in:

 

 

- Patients who have chronic liver disease;

 

 

- Intravenous drug users;

 

 

- Staff and residents of units for people with learning disabilities;

 

 

- Workers who come into direct contact with untreated sewage.

 

 

Contraindications
- Should be postponed in those with severe febrile illness.

 

 

- Hypersensitivity.

 

 

Cautions
- It should not be given during pregnancy unless there is a definite risk of infection.

 

 

Common side-effects
- Transient soreness;

 

 

- Erythema;

 

 

- Induration at the injection site.

 

 

Rare side-effects
- Fever.

 

 

- Malaise.

 

 

- Loss of appetite.

 

 

- Headache.

 

 

- Diarrhoea.

 

 

- Fatigue.

 

 

- Nausea.

 

 

- Myalgia.

 

 

- Arthralgia.

 

 

- Generalised rashes.

 

 

Administration
- Singular intramuscular injection with a booster at 6-12 months.

 

 

- The deltoid site is preferred.

 

 

- The subcutaneous route may be used for people who have haemophilia.

 

 

Nursing considerations
- The decision to immunise should be based on a calculation of the risk of catching hepatitis A while travelling.

 

 

- Nurses should ensure that risk indication comes from an up-to-date and reputable source.

 

 

- Batch number and expiry date should be recorded in the patient’s records.

 

 

Patient teaching
- The patient should be advised of the necessity for food and water hygiene precautions as hepatitis A immunisation does not offer protection against other travel-related illnesses.

 

 

Nurses should refer to manufacturer’s summary of product characteristics and to appropriate local guidelines.

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