A Clinician’s Handbook for Childhood & Adult Immunizations in Georgia
Hepatitis A (HepA)
Pathophysiology
Virus
Transmitted by fecal-oral route with an
Incubation of 15-50 days
Vaccine Description
Inactivated whole virus vaccine
Dose & Route
Note: Both brands are produced in pediatric and adult formulations and are packaged as single dose vials or pre-filled syringes
Havrix™
- Pediatric (12 mos. through 18 years)
0.5 mL given IM - Adult (≥19 years)
1 mL given IM 
Vaqta™
- Pediatric (12 mos. through 18 years)
25 units given IM - Adult (≥19 years)
50 units given IM 
Twinrix™ (HepA & HepB)
- Adult (≥18 years)
1 mL given IM 
Administration Schedule & Minimum Intervals
Havrix™
2 doses
0, 6-12 months
Vaqta™
2 doses
0, 6-18 months
Twinrix™ (HepA & HepB)
3 doses
0, 1, 6 months
Contraindications
Pregnancy is NOT a contraindication for Hep A vaccine
- Anaphylactic reaction following a prior dose of Hep A or to any of its components (alum, 2- phenoxyethanol).
 - Defer vaccination in persons with moderate or severe acute illness until illness subsides.
 
Special Considerations & Instructions
Required for children attending childcare facilities and schools.
- Recommended for all children 12-23 months of age.
 - International travel: infants age 6-11 months give 1 dose before departure; revaccinate with 2 doses, separated by 6-11 months between 12 to 23 months of age. Unvaccinated age 12 months and older give 1st dose as soon as travel considered.
 - At risk groups: men who have sex with men, injection or non-injection drug use, homelessness, work with hepatitis A virus, chronic liver disease, clotting factor disorders, or contact with international adoptee.
 - Post-exposure prophylaxis: Recommendation for PEP have been updated to include Hep A vaccine for all unvaccinated persons aged ≥ 12 months, regardless of risk group, and co- administration of IG when indicated.
 - Recommended that all persons with HIV aged ≥1 be vaccinated with Hep A vaccine.