You can protect yourself against the hepatitis A and B viruses by vaccination. Here you will find all the information about risk groups, the procedure of vaccination, possible side effects, as well as costs incurred, which in many cases are covered by health insurance.
What is hepatitis?
Hepatitis A and B are diseases of the liver, some of which can cause long-term damage to the body. Hepatitis B is the more “dangerous” of the two variants. The viral infection is one of the most widespread in the world and can completely destroy the liver if the disease progresses chronically. The pathogen can enter the organism via blood or other body fluids. The virus can no longer be completely removed from the body, which is why vaccination is the most important and best preventive measure against hepatitis B. Hepatitis A is usually less damaging than hepatitis B, which means that the liver usually does not sustain any permanent damage from the disease. However, hepatitis A only breaks out within 15 to 55 days. Thus, unknowingly infecting others is very likely. Hepatitis A is transmitted by contact and smear infection.
Vaccination against hepatitis
Hepatitis vaccinations are usually given as basic immunizations and can be renewed every ten years thereafter if needed. In fact, protection is thought to last at least ten to twelve years, and boosters are not needed after basic immunization without increased risk of exposure. A combination vaccination against hepatitis A and B is possible in Germany. But it is also possible to vaccinate against both diseases separately. In this case, a so-called dead vaccine is injected. This is called so because the virus is only present in parts and can therefore no longer be transmitted. However, the antibodies are still formed in the body. The vaccinations are usually administered by a doctor.
When is hepatitis B vaccination necessary?
Vaccination should be given primarily to high-risk groups. Whether hepatitis B vaccination is recommended for you depends on whether one or more of the following applies to you:
- You have occupational contact with blood or other body fluids, for example, medical workers, nurses, social workers, police officers or prison staff.
- You have professional or private contact with people suffering from hepatitis, including in the wider circle of acquaintances (for example, kindergarten, sports club) or live or work in a shared accommodation (for example, nursing home, psychiatric ward, prison).
- You have an immune deficiency.
- You are HIV positive.
- You are at increased risk of infection due to sexual behavior, for example, frequently changing sexual partners.
- You are a drug user.
- You have not experienced basic immunization against hepatitis B as a child.
- You are staying abroad in the near future: Risk areas include Australia, Central Africa and Southeast Asia.
Since 1995, newborns in Germany are basic immunization against hepatitis B. The effect of the vaccination lasts into adulthood and can be refreshed every ten years if necessary.
Hepatitis A: risk groups
Vaccination against hepatitis A is recommended if you belong to one of the following risk groups:
- You already have chronic disease of the liver.
- You are regularly injected with blood or blood components.
- Because of your sexual behavior, you are at increased risk of infection.
- You reside in a facility for people with behavioral disorders or cerebral palsy, such as a psychiatric facility.
- You work in a health care setting (including laboratory activities) or in a community setting (such as day care centers, sheltered workshops, etc.).
- You have occupational contact with wastewater, such as in a sewage treatment plant or activities in the sewerage system.
- You are planning a trip to a region at risk: Middle East, Turkey and Asia, Africa and the Mediterranean are considered risk areas.
What is the vaccination process?
For a combination vaccination against hepatitis A and B, three vaccinations are usually necessary to obtain full protection.The first vaccination is given approximately four weeks before the second vaccination and six months before the third vaccination. After the second vaccination, the antibodies are formed. At the third time the protection lasting at least ten to twelve years is achieved. About four to eight weeks after the last vaccination, the blood is examined. If antibodies are found, the hepatitis vaccination has gone according to plan. If there are no or too few antibodies in the body, the fourth vaccination must be given. Of course, both vaccinations can be performed separately. For the hepatitis A vaccination, you only need two vaccinations to be basic immunized.
Non-responders and low-responders to hepatitis vaccination.
Success or antibody formation with hepatitis vaccination can depend on age, gender, pre-existing medical conditions, or other factors such as genetics. Approximately five percent of all vaccinated persons form no or too few antibodies after vaccination. These people are referred to as non-responders or low-responders. For the latter, it is recommended to revaccinate up to three times at intervals of four to eight weeks; for non-responders, there are various strategies under discussion.
Vaccination in infants
Hepatitis B vaccine is usually injected during infancy or early childhood. Vaccination requires three sessions. According to the Federal Joint Committee’s Protective Vaccination Guidelines, babies are given basic immunization against hepatitis B at two, four, and 11 to 14 months of age. Depending on the vaccination schedule, another vaccination may be required at three months of age.
Are there any side effects from the vaccination?
In most cases, the injection is given in the muscle of the upper arm. The vaccine is considered well tolerated. However, side effects such as gastrointestinal problems, fatigue, and redness and swelling at the injection site are possible up to two days after vaccination.
How much does hepatitis vaccination cost?
Per hepatitis A vaccination is to be expected with about 50, – to 65, – Euro. For a basic immunization with two injections, this is about 100,- to 130,- Euro. A hepatitis B vaccination is somewhat more expensive at 50,- to 70,- Euro per injection. A basic immunization with three injections (for an adult) thus costs about 150,- to 210,- Euro. However, since most adults were already vaccinated against hepatitis B as a child, only a booster vaccination is usually charged here. In the case of a combined vaccination against both forms of hepatitis (A and B), about 180,- to 240,- Euro have to be paid for the basic immunization. Depending on the doctor’s office, fees for the consultation and the doctor’s or nurse’s fee are added to the above prices. Here you should expect about up to 40 euros.
Who pays for the vaccination?
Basically, it can be said that for children under 18 years, the hepatitis B vaccination is paid for by all statutory health insurance companies and is strongly recommended. The hepatitis A vaccination in children is paid by the insurance companies depending on the situation (for example, stay abroad, contact with risk group, etc.). Vaccinations against the hepatitis virus in adults are handled as indication vaccinations. This means that the hepatitis A and B vaccinations are recommended for certain risk groups and under certain conditions and are paid for by the health insurance in these cases. If you do not belong to such a risk group, you have to pay for the vaccination yourself. If the hepatitis vaccination is to be carried out as a travel vaccination, the health insurance company decides in each individual case whether there is a risk and the costs are therefore covered.
Cost absorption by the employer
However, there is also the possibility that the employer pays for the vaccination, if occupationally there is a higher probability of coming into contact with the pathogen. This is the case in all professions that come into contact with body fluids, such as nurses, laboratory technicians, workers in sewage treatment plants, pathologists. Here the employer can pay for the hepatitis A and/or B vaccination. If you are not quite sure by your professional and private situation, whether and to which risk group you belong, ask in any case at your health insurance and then your employer, whether a cost coverage for you comes into question.
