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HEPATITIS A VACCINE

Medical Diagnosis and Drugs, Medications
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

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