Hepatitis A vaccination

Vaccination against hepatitis A

Hepatitis A is an inflammatory disease of the liver caused by the hepatitis A virus (HAV). The virus is transmitted fecal-orally, which means that it is transmitted either through food contaminated with feces or through a smear infection, for example through the hands.

It is possible to vaccinate against hepatitis A. There are basically two different ways to vaccinate: active or passive.

With active vaccination, the body is injected with virus components, against which it then actively forms antibodies. The body can "notice“Which means that when exposed to the correct virus, the reaction with antibodies is so rapid that an infection cannot break out.
With passive vaccination, antibodies against the hepatitis A virus are injected directly. Since the body does not have to produce the antibodies itself, they are available more quickly, but the protection is not permanent because it is not "learned“Was to make the antibodies itself.

Active vaccination against hepatitis A should be given to certain people who are at increased risk of infection for one of the following reasons:

  • Travel to countries with a high risk of infection (e.g. Africa, Central and South America and the Mediterranean region),
  • job-related increased risk of infection (for example medical staff, nursing staff or employees in kindergartens or day care centers or in the food industry) or
  • chronic liver disease.

The pure hepatitis A vaccine is vaccinated twice with an interval of 6 to 12 months and then offers safe protection for about 10 years. In the meantime, however, the combination with the vaccine against hepatitis B is more frequently used, in which case three vaccinations must be given.
The vaccination can be carried out from the age of one. It is usually very well tolerated; in only a few cases there is fatigue, discomfort at the injection site such as redness or fever. There is also a combination with a typhoid vaccine.

Read more on the topic: Typhoid vaccination

Passive vaccination is only used in rare cases, for example in pregnant women (as the effects of the active vaccine on unborn babies have not yet been clarified), if there are allergies to components of the active vaccine, in immunocompromised people or in the chronically ill. Here the effect only lasts for about 3 months, but it can be used on babies.

Read also on this topic Twinrix®

Twinrix® vaccine

Twinrix® is a vaccine that protects the liver from both hepatitis A and hepatitis B infections.
Hepatitis A and B are caused by viruses, but have different transmission routes and disease courses. While hepatitis A is mainly transmitted through contaminated food such as water, hepatitis B is mainly transmitted through sexual intercourse, but infection through needle stick injuries or transmission during childbirth is also possible.

Read more on the topic: Twinrix®

Is it a live vaccine?

With Twinrix® as a combination preparation, the active ingredient against hepatitis A and hepatitis B is a dead vaccine. So only dead components or dead pathogens are vaccinated. No part of the vaccination can cause infection.

How often do you have to vaccinate?

In order to achieve adequate vaccination protection, the vaccination is given in three doses over a period of six months.

When does it need to be refreshed?

The responsible vaccination committee of the Robert Koch Institute gives different refreshment recommendations for the two infectious diseases. After vaccination against hepatitis A, a booster should be given after ten years.
The protective period for the hepatitis B vaccination is put at least fifteen years. According to the Robert Koch Institute, a refresher is usually not necessary. If you are not sure, the vaccination protection can be determined by taking a blood sample and then refreshed if necessary.

What is the interval between vaccinations?

There are usually three vaccinations. The first vaccination takes place on the agreed date with the doctor, the second one month later and the third vaccination six months after the first vaccination.
For adults who need quick vaccination protection, for example because of a trip, all three vaccinations can be given in one month. Then, however, twelve months after the first, a fourth vaccination is recommended in order to ensure adequate and safe vaccination protection.

Who is the vaccination useful for?

The vaccination against hepatitis A and hepatitis B is particularly useful for people who travel a lot (especially in tropical and subtropical areas) and for medical staff.

When is vaccination protection available?

Adequate vaccination protection only exists after multiple vaccinations. For this reason, on the advice of the Standing Vaccination Commission of the Robert Koch Institute, as already mentioned, three vaccinations are given over a period of six months.

What are the costs of the vaccination?

The cost of the Twinrix vaccination is around 60 euros per dose, depending on the pharmacy. Three doses, in some cases four, are needed for optimal immunization.

Who pays for the vaccination?

Most health insurance companies adhere to the requirements of the Standing Vaccination Commission (STIKO) when assuming the costs of individual vaccinations. This specifies which vaccinations are required according to the current state of science. Here the recommendation for hepatitis B is fixed, for hepatitis A there is only the recommendation as a travel vaccination.
For this reason, the vaccination for hepatitis A is in most cases not covered by health insurance. Since Twinrix® is a combination preparation, this is not necessarily adopted. It is worth asking your health insurance company before the vaccination.

What side effects can the vaccination have?

Basically, it is important to know that this combination vaccine is a dead vaccination, the components of which are in no way contagious.
Nevertheless, Twinrix or the vaccination combination against hepatitis A and like all other drugs can also have side effects, but these do not have to occur in every vaccinated person.
General symptoms that can occur after the vaccination are headache, tiredness or pain and redness at the injection site.
Diarrhea or nausea can also occur. Less commonly, dizziness, vomiting, and abdominal pain, or a mild upper respiratory infection with fever may occur. There are also a number of side effects, but they only occur rarely or very rarely.

Pain as a side effect

As already mentioned, pain as a result of the vaccination can appear in the form of a headache.
Furthermore, local pain in the area of ​​the puncture site can also occur. Since the vaccination usually takes the form of an injection into a muscle in the upper arm, there is a local displacement of muscle tissue, which is then felt as painful as a sore muscles. As already mentioned, this does not have to occur with every vaccinated person.

Read more on the topic: Pain after vaccination

When is it not allowed to be vaccinated?

Basically, infections with a fever over 38 ° C should not be vaccinated and should be waited for a later date.
A normal cold is usually not a contraindication to vaccination. However, this should be discussed with the attending physician. Furthermore, no further vaccination should be given in the case of already known allergic reactions to the vaccine used.

What should be considered with children?

The vaccination recommendation for children is currently only for hepatitis B. This is done with a combination vaccination from the second month of life with repetition in the third and fourth months of life, as well as a final booster between the eleventh and fourteenth months of life.
The combination vaccination contains additional protection against tetanus, diphtheria, whooping cough, polio and Haemophilus influenzae. If you plan to travel abroad to tropical or subtropical countries, you should also be vaccinated against hepatitis A viruses. Detailed advice should be given to the pediatrician.

Where can I get vaccinated against hepatitis A?

The company doctor is the contact person for medical staff. The rest of the population is advised by the family doctor and also vaccinated.

Can I drink alcohol after a vaccination?

Basically, alcohol does not have a major impact on a successful vaccination. Nevertheless, here, as almost everywhere, the dose makes the poison. So you should make sure that there is no excess. However, alcohol can weaken the body and thereby cause increased vaccination side effects. Since the body and its immune system need all reserves to build up protection, it should not be affected by excessive alcohol consumption.

Can I be vaccinated during pregnancy?

Basically, vaccinations can be divided into live or dead vaccinations. As the name suggests, dead vaccinations contain dead pathogens or parts of them.
Live vaccines contain weakened pathogens that are capable of multiplying. These live vaccines are contraindicated during pregnancy, which means they must not be given. Individual vaccination advice is provided by the attending gynecologist and / or family doctor.

Combination of hepatitis A with yellow fever vaccination

In principle, several vaccinations can be given in parallel. The yellow fever vaccination is one of the recommended travel vaccinations that should be given before traveling to yellow fever areas such as tropical Africa or South America.
It is a live vaccination and offers lifelong protection even after one vaccination. It should be done at least ten days before traveling to an endemic area. The vaccination can then take place in parallel to the Twinrix vaccination in the other upper arm.

Combination of hepatitis A with typhoid vaccination

As with the vaccination against yellow fever, the STIKO recommendation is recommended for travelers to endemic areas. This vaccination can also take place in parallel to an immunization with Twinrix®.