Hepatitis A Vaccine

Key vaccine facts

This vaccine gives protection against the hepatitis A virus, which is a cause of liver infection.

There are three types of hepatitis A vaccine available in the UK:

a vaccine that protects just against hepatitis A
a combined vaccine for hepatitis A and hepatitis B
a combined vaccine for hepatitis A and typhoid

All types of hepatitis A vaccines used in the UK are inactivated. They do not contain any live viruses or bacteria, and cannot cause disease.

Who should have the vaccine?

The risk of infection from hepatitis A is low for most people in the UK, so the vaccine is only available free of charge to people at high risk of hepatitis A disease. This includes:

people planning to visit or live in parts of the world where hepatitis A is common
close contacts of someone who has hepatitis A
people with chronic (long-term) liver disease
people with blood clotting disorders (haemophilia)
men who have sex with men
drug users who inject drugs
people who may be exposed to hepatitis A through their job (including staff working in jobs where people’s personal hygiene may be poor, or people working with monkeys and apes)

In Europe and the UK there is currently an increase in the number of cases of hepatitis A, mainly among men who have sex with men. Most of the UK cases so far have been in London. Public Health England is encouraging gay and bisexual men to practice good personal hygiene and ask about hepatitis A vaccination at their sexual health clinic appointments.

Vaccines are available for adults and for children aged 1 year or older. However, combined hepatitis A and typhoid vaccines are not licensed for children under the age of 15. For some vaccines only one initial dose is needed, and for others two or three doses are needed. Booster doses may also be needed for long-term protection. For more information, ask for the Patient Information Leaflet for the vaccine you are offered.

Ingredients

There are several different makes of hepatitis A vaccine used in the UK. For full information on ingredients, ask for the Patient Information Leaflet for the vaccine you are offered, or look the brand name up on the electronic Medicines Compendium (eMC) .

Apart from the active ingredients (the antigens), all hepatitis A vaccines used in the UK contain very small amounts of this added ingredient:

Aluminium, which strengthens and lengthens the immune response to the vaccine

Hepatitis A vaccines may also contain traces of these products used during the manufacturing process:

neomycin, an antibiotic used to stop bacteria growing and contaminating the vaccine
common salt (sodium chloride) and other harmless sodium and potassium salts used as acidity regulators
a trace of formaldehyde, used to inactivate the viruses for the vaccine

Growing the active ingredients for the vaccines:

the hepatitis A virus strain used to make the vaccines is grown in the laboratory using human cell strains
the combined hepatitis A and B vaccines may contain traces of yeast proteins. These come from the yeast used to grow the hepatitis B proteins for the vaccine. A tiny quantity of yeast protein may remain in the vaccine, but there is no evidence that this can cause allergic reactions. The hepatitis B proteins are grown in yeast cells using recombinant DNA technology.

Side effects

Side effects vary between the different types of hepatitis A vaccine, but can include the following:

Very common (affecting more than 1 in 10 people at each dose):

pain at the injection site
redness and hardness at the injection site
headache
feeling tired, irritable, weak or generally unwell
loss of appetite or feeling sick
upset stomach or diarrhoea

Common (affecting up to 1 in 10 people at each dose):

a slightly raised temperature (fever)
swelling or a small lump at the injection site
itchy skin
aching muscles
feeling drowsy

Uncommon (affecting up to 1 in 100 people at each dose):

feeling dizzy
stomach pain or being sick

For rarer side effects (affecting fewer than 1 in 1000 people), ask to see the Patient Information Leaflet for the vaccine you are offered.

Anaphylaxis

As with any vaccine, medicine or food, there is a very small chance of a severe allergic reaction (anaphylaxis). Anaphylaxis is different from less severe allergic reactions because it causes life-threatening breathing and/or circulation problems. It is always extremely serious but can be treated with adrenaline. Health care workers who give vaccines know how to do this. In the UK between 1997 and 2003 there were a total of 130 reports of anaphylaxis following ALL immunisations. Around 117 million doses of vaccines were given in the UK during this period. This means that the overall rate of anaphylaxis is around 1 in 900,000.

More information on side effects

Reactions listed under ‘possible side effects’ or ‘adverse events’ on vaccine product information sheets may not all be directly linked to the vaccine. See Vaccine side effects and adverse reactions for more information on why this is the case.

If you are concerned about any reactions that occur after vaccination, consult your doctor. In the UK you can report suspected vaccine side effects to the Medicines and Healthcare products Regulatory Agency (MHRA) through the Yellow Card Scheme . You can also contact the MHRA to ask for data on Yellow Card reports for individual vaccines . See more information on the Yellow Card scheme and monitoring of vaccine safety.