Can the Hepatitis A (HAV) vaccine be given with the Meningococcal B (MenB) vaccine?

Co-administration of Hepatitis A Vaccine with Meningococcal B Vaccine

Yes, the Hepatitis A (HAV) vaccine can be safely and effectively administered simultaneously with the Meningococcal B (MenB) vaccine. This is supported by current immunization guidelines and evidence on vaccine co-administration.

Rationale for Co-administration

The Advisory Committee on Immunization Practices (ACIP) provides guidance on vaccine co-administration:

• MenB vaccines (either MenB-FHbp or MenB-4C) may be administered concomitantly with other vaccines indicated for the age group, but at a different anatomic site if feasible 1
• Inactivated vaccines (such as Hepatitis A) generally do not interfere with the immune response to other inactivated vaccines or live vaccines 1

Administration Considerations

When administering both vaccines simultaneously:

• Use different injection sites for each vaccine
• There is no need to separate the timing between these vaccines
• The immune response to both vaccines is maintained when given together

Specific Guidance for Different Patient Groups

For Healthy Adolescents and Young Adults

• Both vaccines can be administered during the same visit
• For MenB, follow the recommended schedule:
  • MenB-FHbp: 2 doses (0,6 months) for healthy adolescents
  • MenB-4C: 2 doses at least 1 month apart 1
• For Hepatitis A, follow the standard 2-dose schedule

For Persons at Increased Risk for Meningococcal Disease

• Both vaccines can still be co-administered
• For MenB, follow the 3-dose schedule for MenB-FHbp (0,1-2,6 months) or 2-dose schedule for MenB-4C 1
• Hepatitis A vaccination schedule remains unchanged

Important Considerations

1. Vaccine Product Consistency: While both vaccines can be given together, it's crucial that the same MenB vaccine product (either MenB-FHbp or MenB-4C) be used for all doses in a series 1

2. Different Anatomic Sites: When administering both vaccines simultaneously, use different anatomic sites to minimize local reactions 1

3. Documentation: Clearly document which vaccines were administered, including product names and lot numbers

4. Special Populations: For immunocompromised patients, such as those who have undergone hematopoietic cell transplantation, both vaccines are included in the recommended inactivated vaccine schedule starting 6-12 months post-transplant 1

Evidence from Similar Co-administration Studies

While there are no studies specifically examining HAV and MenB co-administration, similar studies support this practice:

• Co-administration of hepatitis A/B combined vaccine with quadrivalent meningococcal conjugate vaccine (MenACWY) showed no reduction in immunogenicity or increased safety concerns 2, 3
• Enterovirus 71 vaccine administered simultaneously with hepatitis B vaccine and group A meningococcal polysaccharide vaccine demonstrated noninferior immunogenicity and comparable safety to separate administration 4

Conclusion

Based on current ACIP guidelines and immunization principles, Hepatitis A vaccine can be safely and effectively co-administered with Meningococcal B vaccine. This approach offers convenience, potentially better compliance, and lower administration costs while maintaining the immunogenicity and safety profile of both vaccines.