Hepatitis A And B: Diseases Of The Liver
Hepatitis is an inflammation of the liver, most often caused by a viral infection. There are three common types of hepatitis caused by viruses: hepatitis A, hepatitis B, and hepatitis C. Vaccines have been developed that protect people from contracting hepatitis A and B. There is no vaccine for hepatitis C.
Hepatitis A and hepatitis B can be spread from person to person, although in different ways. They have similar symptoms, which include abdominal pain, fever, fatigue, joint pain, and jaundice .
Over the last 20 years, there has been a 90% decrease in cases of hepatitis A and an 80% decrease in hepatitis B cases in the U.S. Health experts believe that immunization efforts have led to this drop in rates of infection.
How Is Hepatitis A Diagnosed And Managed
A blood test will confirm whether someone is infected with hepatitis A.
There is no medicine to treat hepatitis A. Your doctor may suggest rest, plenty of fluids and relief for any nausea or pain.
To protect your liver, you should not drink any alcohol while you have hepatitis. Your doctor will advise you what medicines you can take.
If you are diagnosed with hepatitis A, your doctor will need to enter details on the Notifiable Diseases database.
Common And Local Adverse Events
HA vaccine
HA vaccine is well tolerated. Reactions are generally mild and transient, and are usually limited to soreness and redness at the injection site. Other less frequent reactions include headache, irritability, malaise, fever, fatigue and gastrointestinal symptoms. Injection site reactions occur less frequently in children than in adults as do mild, systemic events . No significant difference in reactions is evident between initial and subsequent doses of vaccine or in the presence of pre-existing immunity.
HAHB vaccine
Refer to Hepatitis B Vaccine in Part 4 for information about HAHB vaccine.
Ig
Injection site reactions following receipt of standard human Ig include tenderness, erythema and stiffness of local muscles, which may persist for several hours. Mild fever or malaise may occasionally occur.
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Youll Have To Comparison Shop
It’s not always the case that the lowest price for adult vaccines can be found in public or community health clinics. Invest half an hour of time calling vaccination centers in your area to get price quotes.
Before you call, know which vaccines you need so that you can ask for a price quote on each of those vaccines. You can look up which vaccines are recommended for adults on the Center for Disease Controls adult immunization schedules page.
When comparison shopping vaccination prices, be sure to ask if there are any extra charges to expect in addition to the cost of the vaccine, such as a fee for the office visit.
Some vaccination centers charge an all-inclusive price for each vaccination. Others have a charge for the vaccine itself, a charge for administering the vaccine , an additional charge for the office or clinic visit. These additional charges sometimes cost more than the vaccine.
Some vaccines require a prescription, some dont. Which vaccines require a prescription varies from state to state. For vaccines that require a prescription, you may get the prescription from your primary care physician or other healthcare provider.
Here are some other resources for low-cost adult vaccinations:
Do I Need To Pay For Hepatitis B Immunisation
Vaccines covered by the NIP are free for people who are eligible. See the NIP Schedule to find out which vaccines you or your family are eligible to receive.
Eligible people get the vaccine for free, but your health care provider may charge a consultation fee for the visit. You can check this when you make your appointment.
If you are not eligible for free vaccine, you may need to pay for it. The cost depends on the type of vaccine, the formula and where you buy it from. Your immunisation provider can give you more information.
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What Is Hepatitis A And How Do You Catch It
Hepatitis A is a liver infection caused by a virus. Its usually spread via the stool of someone infected. Parts of the world with poor sanitation, men who have sex with men, and people who inject drugs are most at risk of contracting the infection.
Generally the areas with the highest cases of hepatitis A are those where sanitation and food hygiene are poor. These include parts of Africa, the Indian subcontinents, the Far East, the Middle East and Central and South America.
You can contract hepatitis A in a number of ways:
From someone with the infection not washing their hands thoroughly and preparing food which you eat
Washing hands in contaminated water and preparing food that you eat
Drinking contaminated water
Eating raw or undercooked seafood sourced from contaminated water
Being in close contact with someone who has the infection
Having intercourse with someone with the infection
Injecting drugs using contaminated equipment
The infection is at its most contagious stage in the two weeks before symptoms appear, up until about a week after the symptoms first show.
Hepatitis A And B Vaccines At Sutter Walk
Your liver is one of the hardest working organs in your body. To help keep it healthy throughout your life, Hepatitis A and Hepatitis B vaccinations are strongly recommended.
Sutter Walk-In Care offers Hepatitis A and B vaccinations for those 18 years and older. No appointment necessary. Our care team is ready to answer any questions you may have.
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How Is Hepatitis A Spread
The hepatitis A virus is found in the bowel movements of infected persons. People with hepatitis A infection who use the bathroom without proper hand washing can pass the virus on to others through food preparation or other hand-to-mouth contact. The disease can also be spread by sexual contact, or sharing of equipment used in illegal drug use, such as needles or pipes.
Hepatitis A can also be spread by drinking contaminated water, or by eating raw or under-cooked shellfish, such as crabs, clams, oysters or mussels that have been contaminated with sewage.
Health Insurance And Adult Vaccines
If you need several vaccines, especially if some of the vaccines you require are administered in a series of two or three shots over several weeks or months, you could be looking at costs of several hundred dollars or more.
Health insurance you buy through your states Affordable Care Acthealth insurance exchange must cover routine vaccines recommended by the CDCs Advisory Committee on Immunization Practices. This requirement also applies to individual market major medical plans purchased outside the exchange, employer-sponsored plans, and most student health plans offered by colleges and universities. There are two important caveats about using health insurance for adult vaccines:
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Efficacy And Effectiveness Of Vaccine
Hepatitis A vaccines are highly effective in preventing clinically apparent disease. In one study, 1037 healthy seronegative children 2 to 16 years old in a community with high hepatitis A rates and periodic outbreaks received a single dose of formalin-inactivated vaccine derived from strain CR326F or placebo. No cases of hepatitis A occurred in the vaccinated group beginning 17 days after vaccination. In the placebo group, 34 cases of hepatitis A were observed, yielding an estimated 100% vaccine efficacy, with a lower bound of the 95% confidence interval of 87%.547 In a large field trial of approximately 40,000 Thai children 1 to 16 years old, the efficacy of inactivated vaccine was 94% after two doses administered 1 month apart.380 The efficacy of the virosome-formulated hepatitis A vaccine derived from the RG-SB strain was assessed in a randomized, placebo-controlled, double-blind study among Nicaraguan children ages 1.5 to 6 years. Protective efficacy beginning 6 weeks after vaccination was 100% .548
A 5-year follow up study in India showed that the single dose of live attenuated vaccine is well tolerated and provides long-term immunogenicity in healthy Indian children.564 Another follow-up study demonstrated 10 year protection after administration of Biovac-A.565
Rick D. Kellerman MD, inConn’s Current Therapy 2021, 2021
For Those Needing The First Dose Of The Hepatitis A Vaccine
Individuals
If you are 19 and older and have health insurance:
- Your healthcare provider
- University of Louisville Pharmacy, 550 S. Jackson St.
- 7:30am – 7:00pm Monday – Thursday
- 7:30am – 5:00pm Friday
If you are 19 and older and do NOT have health insurance:FOR THOSE ON MEDICARE: Medicare Part D should cover the cost of your Hepatitis A vaccination. Click HERE for more information you can share with your healthcare provider or pharmacy. Call Medicare or your plan provider first to understand any restrictions or cost that may be involved.
For hepatitis A vaccines for children contact:
- Your healthcare provider
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Who Should Get Immunised Against Hepatitis A
Anyone who wants to protect themselves against hepatitis A can talk to their doctor about getting immunised.
Hepatitis A immunisation is recommended for:
- Aboriginal and Torres Strait Islander children who live in Queensland, the Northern Territory, Western Australia or South Australia, at 18 months and 4 years for free under the National Immunisation Program
- People who regularly provide care for Aboriginal and Torres Strait Islander children in Queensland, the Northern Territory, Western Australia or South Australia
- children at least 12 months old and adults who are travelling to areas where hepatitis A is common
- people who live or work with rural or remote Aboriginal and Torres Strait Islander communities
- people who work in early childhood education and care
- people with developmental disabilities, and their carers
- plumbers and sewage workers
Your doctor can tell you which vaccine they will use for your hepatitis A immunisation.
Who Should Get The Hepatitis A Vaccine
Over the last 15 years, there have been many outbreaks of hepatitis A in Aboriginal communities in B.C., and so the hepatitis A vaccine has been offered to all Aboriginal children and adolescents aged 6 months to 18 years living both on-reserve and off-reserve since January 1, 2012.
The hepatitis A vaccine is also recommended for, and provided free to, the following people at high risk of infection:
- Those who have hemophilia or receive repeated infusions of blood or blood products.
- Those who inject illegal drugs or share drug snorting, smoking, or injecting equipment.
- Males who have sex with other males.
- Those with HIV, hepatitis B or hepatitis C infection, or chronic liver disease.
- Those who have had a stem cell transplant.
- Those who will have or have had a liver transplant.
- Inmates of a correctional facility.
- Those who are in close contact with persons infected by the hepatitis A virus such as people living in the same house, sexual partners, close friends, and children in the same daycare.
- Those who have eaten food prepared by a food handler with hepatitis A infection.
If you may have been exposed to hepatitis A, you should get 1 dose of the vaccine within 14 days of the exposure to prevent disease. This is provided for free.
The vaccine is also recommended, but not provided free, for people likely to come in contact with or spread the hepatitis A virus, including:
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How Can Hepatitis A Be Prevented
The most important and effective action to protect against hepatitis A – particularly for those at higher risk – is to get vaccinated.
The inactivated hepatitis A vaccine is highly effective and induces nearly 100 per cent protection within four weeks after vaccination. Receiving a second dose, given at least six months later, provides lifelong immunity.
Free hepatitis A vaccine is available in Victoria until 30 June 2018 for all MSM, people who have injected drugs in the past 12 months, homeless people who are sleeping rough, and adult prisoners. The vaccine should be offered to all patients from these groups.
Practising good personal hygiene can reduce the spread of hepatitis A, especially in food handlers. This means everyone should:
- wash their hands thoroughly in soap and running water after visiting the toilet, before eating and before handling food
- wash their hands and their lower areas after sex
- make sure they’re using condoms and changing condoms between any sexual activity.
People who inject drugs can reduce the spread of hepatitis A by:
- not sharing or re-using needles, spoons, swabs, water or any other equipment
- taking special care when injecting in groups, or when being injected by others
- labelling or marking their syringes
- washing their hands in warm soapy water before and after injecting, and swabbing the injection site with alcohol swabs
- not recapping someone else’s needles when using in groups or injecting others.
What Are The Possible Reactions After The Vaccine
Vaccines are very safe. It is much safer to get the vaccine than to get hepatitis A.
Common reactions to the vaccine may include soreness, redness and swelling where the vaccine was given. Headache, fatigue, fever, and stomach upset may also occur after getting the vaccine. These reactions are mild and generally last 1 to 2 days.
For more information on Reye Syndrome, see HealthLinkBC File #84 Reye Syndrome.
It is important to stay in the clinic for 15 minutes after getting any vaccine because there is an extremely rare possibility, less than 1 in a million, of a life-threatening allergic reaction called anaphylaxis. This may include hives, difficulty breathing, or swelling of the throat, tongue or lips. Should this reaction occur, your health care provider is prepared to treat it. Emergency treatment includes administration of epinephrine and transfer by ambulance to the nearest emergency department. If symptoms develop after you leave the clinic, call 9-1-1 or the local emergency number.
It is important to always report serious or unexpected reactions to your health care provider.
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What Are The Symptoms Of Hepatitis A
Adults who get hepatitis A usually develop symptoms, which include fever, nausea, vomiting and abdominal discomfort, followed by dark urine and yellow skin/eyes . Sometimes only some of these symptoms are present. Symptoms may last for several weeks, but full recovery usually occurs.
Symptoms of hepatitis A infection take between 15 to 50 days to develop after exposure, and on average around four weeks after exposure.
Hepatitis A does not cause long term liver disease, but can be more severe in people with other conditions such as hepatitis B, or hepatitis C or HIV. Hepatitis A can be fatal in up to 2 per cent of cases in people aged over 50 years.
Up to 30 per cent of adults and 70 per cent of children under the age of five show no symptoms at all, however they are still capable of spreading hepatitis A.
Hepatitis B Immunisation Service
Hepatitis B vaccines are given as a needle, either on their own or as a combination vaccine. They can be provided by a variety of recognised immunisation providers. If you’re eligible, you can get the hepatitis B vaccine for free under the National Immunisation Program .
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Find information that will help you deliver your service to your patients
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Do I Need To Pay For Hepatitis A Immunisation
Vaccines covered by the NIP are free for people who are eligible. See the NIP Schedule to find out which vaccines you or your family are eligible to receive.
Eligible people get the vaccine for free, but your health care provider may charge a consultation fee for the visit. You can check this when you make your appointment.
If you are not eligible for free vaccine, you may need to pay for it. The cost depends on the type of vaccine, the formula and where you buy it from. Your immunisation provider can give you more information.
How Is Hepatitis A Transmitted
Hepatitis A usually spreads through ingestion of virus from food, drink or objects contaminated by small, undetected amounts of stool from an infected person. It can also spread through close contact with an infected person, for example through sex or through caring for a person who is infectious with hepatitis A.
Symptoms of hepatitis A infection take between 15 to 50 days to develop after exposure, and on average around four weeks after exposure.
People with hepatitis A are usually infectious to others from two weeks prior to developing symptoms, and up until one week after yellowing of the eyes or skin .
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Vaccines For Hepatitis A And B
Our immune system battles foreign invaders every day, such as when we get a cold virus. When this happens, we develop immunity to that specific virus. This means that our body will fight off the virus if it is ever exposed to it again.
The same protection happens with vaccines. However, the benefit of a vaccination is that you don’t have to go through being sick to enable your body to fight off disease.
Gregory Poland, MD, director of the Mayo Clinic’s Vaccine Research Group, explains that hepatitis vaccinations contain a small amount of the inactive virus. When you get a dose of the vaccine, he says, your immune cells respond by developing immunity against the virus. This immunity lasts over a long period of time.
“So if I get these two doses of hepatitis A vaccine, and then I get exposed 30 years from now, my body will remember that immunity to the vaccine and rapidly start producing antibodies again,” says Poland.
Due to the way hepatitis vaccinations are developed, it is impossible to contract the virus from the vaccine itself, according to Poland.
The hepatitis A vaccine is usually given in two shots and the hepatitis B vaccine is administered as a series of three shots. The most common side effects are redness, pain, and tenderness where the shots are given.
To get long-term protection from these viruses, it’s important to receive all the shots as scheduled. However, if you received one shot and never went back for the others, it’s not too late to catch up.