Hepatitis A Vaccines
New Hepatitis A Vaccine Information Statement (VIS) Published
October 31, 2011 -- The Hepatitis A VIS has been updated. Note that the format has changed slightly. Providers should begin using the updated VIS immediately. However, because this update doesn't affect contraindications or adverse events, providers may choose to use existing stores of the existing VIS. Major changes include the indications for families with newly arriving adopted children and post-exposure prophylaxis.
This updated VIS has been integrated into the Florida SHOTS™ (Florida State Health Online Tracking System ), so registry users can access them electronically. Healthcare providers should periodically access the VIS electronically and print out a supply for routine distribution. If necessary, bureau staff can FAX copies to providers without internet access.
Update on Supply of Merck & Co., Inc. Vaccines
November 16, 2007 -- The Centers for Disease Control and Prevention (CDC) maintains a webpage with the latest national information about vaccine supplies and provides guidance to healthcare providers who are facing vaccine shortages or delays at: http://www.cdc.gov/vaccines/vac-gen/shortages/default.htm.
Hepatitis A
Merck & Co., Inc., is experiencing production delays for Pediatric and Adult hepatitis A vaccine (Pediatric & Adult VAQTA®), resulting in backorders for these products. Merck has temporarily discontinued accepting orders for Pediatric VAQTA® and Adult VAQTA® in the vial formulation. Based on current information, it is estimated that VAQTA® will be available in late first quarter 2008, but actual timing will be confirmed when more is known. There is no change in the routine recommendation. Please see the letter from Merck & Co., Inc. regarding its current vaccine supply status at the link above. GSK production and supply of its Pediatric and Adult hepatitis A vaccine (Pediatric & Adult Havrix®) and Adult hepatitis A/hepatitis B combination vaccine (Twinrix®) are currently in good supply to meet demand. GSK has initiated plans to increase production of Havrix® and Twinrix®, to help ensure uninterrupted supply for the U.S. market.
Please be assured that the Florida Vaccines for Children (VFC) Program has sufficient Haemophilus influenzae type B, Varicella, and Hepatitis A vaccine available. The bureau will provide vaccine supply updates as indicated.
Prevention of Hepatitis A After Exposure to Hepatitis A Virus and in International Travelers
Updated Recommendations of the Advisory Committee on Immunization Practices
October 29, 2007 -- This report details updated recommendations, made by the Advisory Committee on Immunization Practices (ACIP) in June 2007, for prevention of hepatitis A after exposure to hepatitis A virus (HAV), and in departing international travelers, and incorporates existing ACIP recommendations for prevention of hepatitis A. Persons who recently have been exposed to HAV, and who previously have not received hepatitis A vaccine, should be administered a single dose of single-antigen vaccine or immune globulin (IG) (0.02 mL/kg) as soon as possible. For healthy persons 12 months to 40 years of age, single-antigen hepatitis A vaccine at the age-appropriate dose is preferred to IG because of vaccine advantages that include long-term protection and ease of administration. For persons aged greater than 40 years, IG is preferred because of the absence of information regarding vaccine performance and the more severe manifestations of hepatitis A in this age group; vaccine can be used if IG cannot be obtained. IG should be used for children less than 12 months of age, immunocompromised persons, persons who have had chronic liver disease diagnosed, and persons for whom vaccine is contraindicated.
Persons administered IG for whom hepatitis A vaccine also is recommended for other reasons, should receive a dose of vaccine simultaneously with IG. The updated recommendations for use of hepatitis A vaccine alone for postexposure prophylaxis do not apply to the combination hepatitis A/hepatitis B vaccine. Please review the full recommendation online at http://www.cdc.gov/mmwr/pdf/wk/mm56d1219.pdf.
Food and Drug Administration Approval of an Alternate Dosing Schedule for Twinrix®
April 2007 -- In April 2007, GlaxoSmithKline Vaccine Division (GlaxoSmithKline Biologicals) received approval from the Food and Drug Administration (FDA) for an alternate schedule for Twinrix®, a combined hepatitis A and hepatitis B vaccine.
Hepatitis A Vaccine
The Bureau of Immunization is pleased to announce the addition of Hepatitis A vaccine to the list of products available for eligible children through the Vaccines For Children (VFC) Program. Hepatitis A vaccine is now recommended for administration to all infants beginning at 12 months of age.
An advisory committee to the Centers for Disease Control and Prevention (CDC) has recommended that all children in the United States receive Hepatitis A vaccine. The previous recommendation of the Advisory Committee on Immunization Practices (ACIP), in 1999, called for vaccinations in states with the highest rates of Hepatitis. About two-thirds of cases are now reported from states in which Hepatitis A vaccination of children was not recommended. The ACIP recommendation is for children to receive the first dose of a two-dose series of Hepatitis A vaccine between one and two years of age, and the vaccine be integrated into the routine childhood vaccination schedule. Provisional Recommendations by the Advisory Committee on Immunization Practices (ACIP) for Hepatitis A Vaccination of Children can be accessed at http://www.cdc.gov/vaccines/recs/provisional/default.htm.
The ACIP continues to recommend Hepatitis A vaccination for: travelers to countries with a high prevalence of Hepatitis A; men who have sex with men; illegal drug users; and persons with chronic liver disease.
Please remember that by Federal law, all vaccine providers must give patients, or their parents, or legal representatives the appropriate Vaccine Information Statement (VIS) whenever a vaccination is given. The VIS for Hepatitis A can be found at the following website: http://www.cdc.gov/vaccines/pubs/vis/default.htm#hepa.
Hepatitis A vaccine became available for children aged 12-23 months in 2005, allowing for its incorporation into the routine early childhood vaccination schedule. Hepatitis A vaccine is now recommended for universal administration to all infants beginning at 12 months of age. The Advisory Committee on Immunization Practices (ACIP) recommendation is for children to receive the first dose of a two-dose series of hepatitis A vaccine between one and two years of age and that the vaccine be integrated into the routine childhood vaccination schedule. The following recommendations for hepatitis A vaccination are intended to further reduce hepatitis A morbidity and mortality in the United States. Nationwide hepatitis A vaccination of children is likely to result in lower overall rates of Hepatitis A Virus (HAV) transmission and elimination of indigenous HAV. Hepatitis A vaccination is recommended routinely for children, for persons who are at increased risk for infection, and for any person wishing to obtain immunity.
Children
- All children should receive hepatitis A vaccine at 1 year of age (i.e., 12-23 months). Vaccination should be completed according to the licensed schedules and integrated into the routine childhood vaccination schedule. Children who are not vaccinated by 2 years of age can be vaccinated at subsequent visits.
- States, counties, and communities with existing hepatitis A vaccination programs for children 2-18 years of age are encouraged to maintain these programs. In these areas, new efforts focused on routine vaccination of children 1 year of age should enhance, not replace, ongoing programs directed at a broader population of children.
- In areas without existing hepatitis A vaccination programs, catch-up vaccination of unvaccinated children 2-18 years of age can be considered. Such programs might especially be warranted in the context of increasing incidence or ongoing outbreaks among children or adolescents.
Please Note: The Bureau of lmmunization will provide Hepatitis A vaccine to all VFC-eligible children for whom the vaccine is indicated. You may view the ACIP for Hepatitis A vaccine in its entirety at http://www.cdc.gov/mmwr/PDF/rr/rr5507.pdf. The ACIP recommendations are found at http://www.cdc.gov/vaccines/pubs/ACIP-list.htm.
