What are the recommendations for administering the Hepatitis A (Hepatitis A virus) vaccine to a 5-year-old female?

From the Guidelines

I strongly recommend that a 5-year-old female should receive the hepatitis A vaccine as part of her routine childhood immunization schedule, as it provides long-lasting protection against hepatitis A virus infection. The vaccine is typically administered as a two-dose series, with the first dose given at 12-23 months of age and the second dose given 6-18 months later 1. If she hasn't received the vaccine yet, she should start the series now. The pediatric formulation (Havrix 720 EL.U. or Vaqta 25 U) is given as an intramuscular injection in the deltoid muscle.

Key Points to Consider

• Common side effects include soreness at the injection site, headache, and fatigue, which are generally mild and resolve within a few days 1.
• The hepatitis A vaccine is important because it provides protection against hepatitis A virus infection, which can cause liver inflammation, nausea, vomiting, and jaundice.
• Children often have mild or no symptoms but can spread the infection to others.
• The vaccine is highly effective, with more than 95% of children developing protective antibodies after completing the two-dose series, as supported by the most recent guidelines from 2018 2.
• This protection is long-lasting and may provide immunity for 20 years or more.

Administration and Dosage

• The dosage of the hepatitis A vaccine is typically 720 EL.U. or 25 U, given as an intramuscular injection in the deltoid muscle.
• The vaccine can be coadministered with other childhood vaccines without decreasing immunogenicity 1.

Special Considerations

• Hepatitis A vaccine is contraindicated in people with a history of severe allergic reaction to a previous dose of hepatitis A vaccine or to a vaccine component 1.
• No special precautions are needed for administration to people who are immunocompromised, as the hepatitis A vaccine is an inactivated product 1.

From the FDA Drug Label

HAVRIX is approved for use in persons 12 months of age and older. Children and adolescents: A single 0.5-mL dose and a 0.5-mL booster dose administered between 6 to 12 months later.

The Hepatitis A vaccine can be administered to a 5-year-old female.

• Dosage: A single 0.5-mL dose and a 0.5-mL booster dose administered between 6 to 12 months later 3.
• Approved age range: The vaccine is approved for use in persons 12 months of age and older 3, 4.

From the Research

Hepatitis A Vaccine in 5-Year-Old Female

• The hepatitis A vaccine is recommended for children aged 2 years or older, including 5-year-old females, as it is immunogenic and protective in this age group 5.
• A single dose of the vaccine can induce antibody production in 88% to 96% of subjects by 2 weeks and 97% to 100% by 1 month, providing protection against subsequent hepatitis A virus (HAV) disease 5.
• The major pediatric indications for the hepatitis A vaccine include travelers to areas with intermediate to high rates of endemic hepatitis A, children living in communities with high endemic rates or periodic outbreaks of HAV infection, and patients with chronic liver disease 5.

Efficacy and Safety

• The hepatitis A vaccine has been shown to be effective in preventing hepatitis A infection in children, with a low rate of adverse effects 6, 7, 8.
• A study comparing the hepatitis A vaccine with immune globulin for postexposure prophylaxis found that the vaccine provided good protection after exposure, although the rates of hepatitis A were slightly higher in vaccine recipients 6.
• Another study found that the hepatitis A vaccine was well-tolerated and induced a strong immune response in adults, with anti-HAV geometric mean titers (GMT) rising to 73-fold greater than the peak GMT seen after immune globulin administration 7.

Special Considerations

• For children with autoinflammatory diseases on canakinumab and tocilizumab treatments, the hepatitis A vaccine has been shown to be effective and safe, with no disease flares or adverse effects related to vaccination observed 9.
• However, long-term follow-up data are needed to draw a solid conclusion about the safety of the hepatitis A vaccine in patients receiving these therapies 9.