To prevent infection with the hepatitis A virus, vaccination offers the best protection. It is generally well tolerated, so mild side effects rarely occur. If only one vaccination against hepatitis A is given, two doses are required. If, on the other hand, a combination vaccine against hepatitis A and B is used, three vaccinations are required. After that, one is protected for at least twelve years, a booster is recommended after ten years at the earliest. The cost of the vaccination must often be borne by the patient.
Active and passive vaccination
In general, a distinction is made between active and passive vaccination for hepatitis A. Active vaccination is done with a dead vaccine that contains parts of the hepatitis A virus. There is no risk that the vaccine will cause hepatitis A disease. The vaccination causes antibodies to be formed in the body against the pathogen. If an infection occurs at a later time, these catch the viruses and prevent the disease from breaking out. In certain groups of people, human antibodies are used instead of the dead vaccine. This is called passive vaccination. The procedure is used, among others, in chronically ill people or people with a weakened immune system. Likewise, this type of vaccination is used when there is an allergy to a component of the normal vaccine. However, the protective effect lasts for only three months.
Two vaccination appointments necessary
If only one vaccination against hepatitis A is given, vaccination must be given at two different times. After that, basic immunization is complete. After the first vaccine dose, antibodies to the hepatitis A virus are present in the blood of about 95 percent of patients. It takes about 12 to 15 days for the antibodies to form. Because of the rapid effect, the vaccination can also be given shortly before a trip. The second vaccination should be given about six to twelve months after the first. After that, those affected are protected against infection with the pathogen for at least twelve years. According to estimates, however, the vaccination is effective for much longer – possibly closer to 20 to 25 years. Nevertheless, it is recommended for risk groups to refresh the vaccination protection after ten to twelve years.
Who should get vaccinated?
Hepatitis A vaccination is generally recommended for the following groups of people:
- Travelers going to an area at increased risk for hepatitis A infection.
- Individuals with chronic liver disease.
- People who are more likely to be transferred blood components, for example, hemophilia.
- People who work in hospitals or nursing homes, day care centers or children’s homes or the police.
- People who come into direct contact with wastewater such as workers in sewage treatment plants.
- Homosexual men.
Side effects of vaccination
The hepatitis A vaccine is injected into the muscle – either buttocks, upper arm or thigh – and is generally considered well tolerated. Nevertheless, side effects can sometimes occur. These primarily include mild redness and swelling at the injection site. Mild symptoms such as fatigue, an increase in body temperature and gastrointestinal complaints may also occur. Which side effects occur always depends on the vaccine used. Therefore, talk to your doctor about possible side effects before the procedure.
Combined hepatitis A and B vaccination.
Hepatitis A vaccination can be given as a single vaccination or in combination with hepatitis B or typhoid fever. If a vaccine against hepatitis A and B is chosen, vaccination must be given a total of three times until basic immunization is achieved. Similar to the single vaccination against hepatitis B, two vaccinations must be given at intervals of four weeks. The third vaccination, which provides long-term protection of at least ten to twelve years, should be given between six and twelve months after the first injection. In the case of a short-term trip, where it is not possible to complete the basic immunization beforehand, vaccination according to a different schedule is also possible. In this case, the second dose is administered one week, and the third dose three weeks after the first vaccination. In such a case, it makes sense to be vaccinated with a fourth dose after about twelve months.
Cost of vaccination
Costs for travel vaccinations are not always covered by health insurance for adults. Some insurance companies reimburse the fee if the vaccination is recommended by the Permanent Vaccination Commission of the Robert Koch Institute (STIKO). Others only pay the fee the doctor charges for injecting the vaccine. Therefore, you should always check with your health insurance company regarding coverage. If the hepatitis A vaccination is recommended due to occupational exposure, the cost is usually covered by the employer. The cost of a hepatitis A vaccination depends on the vaccine used. This costs about 50 euros per injection. In addition, there are the costs that the doctor charges for the vaccination itself. These can vary, depending on which rate the doctor uses for his calculations. The cost of a combined vaccination against hepatitis A and B is about 230 euros.
