Everything You Need to Know About the Hepatitis A Vaccine

Introduction

Hepatitis A is a contagious liver infection caused by the hepatitis A virus (HAV), which primarily spreads through feco-oral route, and contaminated food, water or close contact with an infected person. It remains a significant public health concern, especially in areas with inadequate sanitation and limited access to clean water¹.  

Most people recover fully and develop a long-lasting immunity against the HAV once they have been affected. However, in rare cases, hepatitis A can lead to severe complications, including liver failure (more common in older adults with underlying conditions). Fortunately, a safe and effective vaccine is available that offers reliable protection against this preventable disease². In this article, we will discuss the hepatitis A vaccine for adults and children, its benefits, and why it’s important for public health. 

What is the Hepatitis A Vaccine?

The hepatitis A vaccine uses an inactivated HAV virus to safely stimulate the body’s immune system and provide long-term protection (possibly life long after two doses) against infection³. 

When a vaccine is given, the white blood cells (WBCs) that fight an infection recognise the vaccine’s antigen (specific virus protein) and trigger specific WBCs (B and T cells). The B  cells then multiply and create antibodies (proteins) and the T cells help in immune regulation and memory for protection against the virus when encountered in the future⁴.  

Bonus: The vaccine also contains aluminium that boosts the immune response by keeping the antigen at the injection site longer and stimulating immune cells to release signals that enhance protection⁴. 

Why is the Hepatitis A Vaccine Important?

The hepatitis A vaccine plays a crucial role in offering protection from the harmful effects of the HAV. Key hepatitis A vaccine uses include: 

• Protects against liver inflammation caused by the HAV⁴. 
• Trains the immune system to recognise the HAV and fight rapidly upon exposure³.
• Helps avoid severe illness and complications from hepatitis A (more common in older adults with liver diseases)¹. 
• Reduces the spread of the virus in communities, lowering outbreak risks⁴. 
• Contributes to overall public health by decreasing disease incidence³. 

Hepatitis A Vaccine (HAV) is not part of India’s National Immunization Schedule currently however the Indian Academy of Paediatrics (IAP) has recommended to include it in NIS due to the disease burden^12,13,14.

Dr. Nayana Shetty, MBBS, MD

Who Should Get the Hepatitis A Vaccine?

The hepatitis A vaccine is generally recommended for individuals at increased risk of infection or complications. The following groups of people are especially advised to get vaccinated against the HAV: 

• All children aged 1 year and older. 
• Travellers to countries or regions with a high prevalence of hepatitis A⁵. 
• People with chronic liver disease⁴. 
• Men who have sex with men (MSM). 
• People who use injection (or non-injection) drugs⁴. 
• Individuals experiencing homelessness⁵. 
• People with clotting factor disorders, such as haemophilia⁴. 
• Family members of individuals recently adopted from a place where hepatitis A is common⁵. 

Indian Academy of Pediatrics (IAP) Recommendations

• The Indian Academy of Pediatrics (IAP) recommends routine hepatitis A vaccination for children, beginning at 12 months of age. Depending on the vaccine used, children may receive either a single dose of a live attenuated vaccine or two doses of an inactivated vaccine administered according to the manufacturer’s recommended schedule. .
• This recommendation is particularly relevant in India due to the changing epidemiology of hepatitis A. improvements in sanitation have reduced natural exposure during early childhood, leaving more older children and adults susceptible to infection, which is often associated with more severe disease.  For this reason, the IAP has advised including the hepatitis A vaccine in routine immunisation practice, even though it is not yet part of India’s National Immunization Schedule.

Types of Hepatitis A Vaccines

There are several types of hepatitis A vaccines available in the market currently that provide effective protection against HAV. These include both single-antigen vaccines and combination vaccines⁶: 

1. Single-Antigen Hepatitis A Vaccines

These vaccines protect only against the HAV. These are approved for individuals aged 1 year and older and include: 

• Havrix® (manufactured by GlaxoSmithKline) 
• Vaqta® (manufactured by Merck & Co.) 

Only inactivated vaccines are in use currently; no live-attenuated Hep A vaccines are licensed in most countries, including the U.S. Both of these are also inactivated vaccines and require a two-dose schedule for long-term protection. 

2. Combination Vaccine

This vaccine (inactivated) protects against both hepatitis A and hepatitis B viruses. They are approved for use in individuals aged 18 years and older and include: 

• Twinrix® (manufactured by GlaxoSmithKline) 

It is important to note that this vaccine is not a replacement for single-antigen vaccines and used when protection against both Hepatitis A and B is needed.  

Since both vaccines are equally effective, your doctor can help determine the most suitable option based on age, health status, and risk of exposure. 

Choosing a combination vaccine can offer practical advantages: it may reduce the total number of injections compared with receiving separate hepatitis A and hepatitis B vaccines, while providing protection against two serious liver infections through a single vaccination schedule. . It may be especially useful for travellers, adults who need protection against both infections, and people at occupational risk of exposure to either virus.

Importantly, the combination vaccine is not a replacement for single-antigen vaccines as it’s used specifically when protection against both hepatitis A and B is needed. Both the combination vaccine and the single-antigen hepatitis A vaccine provide effective protection against hepatitis A when administered according to the recommended schedule. Your doctor can help determine the most suitable option based on your age, health status, vaccination history, and risk of exposure. 

Cost Comparison of Common Hepatitis A Vaccines

The cost of the hepatitis A vaccine can vary depending on the brand, type, and where it is administered. The table below provides a general comparison of commonly used vaccine brands¹⁵. 

Note: Vaccine prices are not fixed and can change over time. They vary by city, healthcare provider, pharmacy, and whether the vaccine is given at a private clinic or a public health facility. The figures available online or elsewhere should be treated only as a rough guide. For current and accurate pricing, it is best to consult your healthcare provider, local pharmacy, or vaccination centre before making a decision. 

When and How Often to Get the Hepatitis A Shot?

The hepatitis A vaccine for adults and children is typically given as part of a two-dose schedule for full protection. Here’s what you need to know about the hepatitis A vaccine dose schedule⁴. 

Single-antigen hepatitis A vaccines are given in two doses⁴: 

• The first dose is recommended at 1 year of age or older. 
• The second dose is usually given 6 to 18 months later. Please note that while this is the suggested time interval, there is no maximum limit and a delayed second dose does not require restarting the series. 

Combination hepatitis A vaccines are given in three doses: 

• The first dose is recommended at 18 years of age or older⁶. 
• The second dose is usually given after 1 month of the first dose. 
• The third dose is generally given 5 months after the second dose (6 months after the first dose)⁴. 
• In combination vaccines, an accelerated schedule (doses at 0, 7, and 21 to 30 days, followed by a booster at 12 months) can be used in certain situations, such as for travellers⁷.  

For optimal effectiveness of the vaccine, you should follow your doctor’s suggestion for the hepatitis A vaccine dose schedule. 

A single dose offers good early protection, but completing the full schedule is important for long-lasting immunity3,9. The first dose primes the immune system, while the later dose (or doses) strengthens and prolongs the protective response, helping ensure immunity that may last for many years. Missing the second dose may leave protection incomplete over the long term. Importantly, a delayed dose does not require restarting the series, so if you have missed a scheduled dose, you can simply complete it later under your doctor’s guidance⁵

Note: The optimal hepatitis A vaccine age to start immunisation is 12 months, ensuring early protection during childhood. That being said, there is no upper limit for the hepatitis A vaccine age, and adults at risk can be vaccinated safely at any time. 

Also Read: Everything To Know About the Influenza Vaccine & Its Importance

How the Vaccine is Given?

The hepatitis A vaccine is administered as an intramuscular injection, typically into the thigh for infants and toddlers (under 3 years) and into the upper arm for children aged 3 years and older and adults⁴.  

It is typically given at clinics, travel health centres, hospitals, or public health departments⁸. If you’re unsure about when or where to get vaccinated, consult your doctor for guidance and support. 

The vaccine has a well-established record of safety and effectiveness: 

• Over 95% of recipients develop protective immunity after the first dose⁹. 
• Full vaccination, after two doses, offers long-lasting immunity (up to 20 years)³. 

Post-Exposure Prophylaxis (PEP) After Hepatitis A Exposure

What is Post-Exposure Prophylaxis?

Post-exposure prophylaxis (PEP) refers to protective measures taken after a person has recently been exposed to the hepatitis A virus, with the aim of preventing infection before it takes hold. In many cases, the hepatitis A vaccine itself can be used as PEP¹⁶.

When It May Be Needed?

PEP may be considered in situations such as:

• Household exposure, for example when a family member is diagnosed with hepatitis A.
• Close personal contact with an infected person.
• Exposure through contaminated food, such as eating food prepared by an infected food handler

Timing Matters

• Timing is key when it comes to PEP. The hepatitis A vaccine is most effective as post-exposure protection when given as early as possible, ideally within approximately 2 weeks of exposure. The sooner it is given after exposure, the better the chance of preventing infection.
• In some cases, particularly for certain high-risk individuals such as older adults, those with chronic liver disease, or people with weakened immune systems, a doctor may recommend immune globulin in addition to the vaccine for added protection.
• Because the window for effective protection is short, it is important to consult a doctor immediately after a suspected exposure to hepatitis A. Your doctor can assess your risk and advise the most appropriate course of action.

Possible Hepatitis A Vaccine Side Effects

This vaccine is generally well tolerated, with most hepatitis A vaccine symptoms being mild and short-lived. Some common but mild hepatitis A vaccine side effects include⁴: 

• Soreness or redness at the injection site 
• Mild fever 
• Fatigue or tiredness 
• Headache 
• Occasional rash 

These hepatitis A vaccine side effects typically get better on their own in a few days. 

Serious side effects such as anaphylaxis (difficulty breathing, swelling of the face or throat, or hives) may also occur, although extremely rare¹⁰. 

Hepatitis A vaccine prevents infection from hepatitis A virus. This infection is typically contracted through contaminated food and can lead to loose motions and jaundice along with high fever.

Dr. Nayana Shetty, MBBS, MD

When to See a Doctor?

While most people experience no or only mild hepatitis A vaccine after effects, you should seek medical attention if you notice: 

• Signs of a severe allergic reaction (anaphylaxis).  
• Persistent or worsening symptoms after vaccination. 
• Any unusual or severe health changes following the shot. 

If in doubt, always consult your doctor for reassurance and appropriate care regarding the hepatitis A vaccine’s effects. 

Conclusion

Hepatitis A vaccine plays a vital role in preventing acute hepatitis A, which can lead to severe liver problems, especially in older adults or those with pre-existing liver disease. This vaccination is especially important for young children, travellers to high-risk regions, MSM, IV drug abusers and individuals with chronic liver conditions. By getting vaccinated, you not only protect yourself but also help stop the spread of the virus in the community. 

The vaccine is safe, effective, and well-tolerated, providing long-term protection and helping lower the incidence of hepatitis A cases worldwide. The hepatitis A vaccine after effects are also usually mild and resolve within a few days without any treatment.  

So, if are not vaccinated or in the high-risk group , talk to your doctor about hepatitis A vaccination; it’s a simple and reliable step toward safeguarding your liver health!

Also Read: HPV Vaccine: What is It, When to Be Taken, Importance & Side Effects 

Frequently Asked Questions (FAQs)

References

1. Girish V, Grant LM, John S. Hepatitis A [Internet]. StatPearls Publishing; [cited 2025 Jun 4]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459290/ 
2. World Health Organization. Hepatitis A [Internet]. World Health Organization; [cited 2025 May 28]. Available from: https://www.who.int/news-room/fact-sheets/detail/hepatitis-a 
3. Zhang L. Hepatitis A vaccination. Hum Vaccin Immunother. 2020 Jul 2;16(7):1565-1573. Available from: https://pmc.ncbi.nlm.nih.gov/articles/pmid/32649265/ 
4. Bhandari P, Brett C, Batool A, et al. Hepatitis A Vaccine [Internet]. StatPearls Publishing; [updated 2023 Jun 21; cited 2025 Jun 4]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK554604/ 
5. Centers for Disease Control and Prevention. Hepatitis A Vaccine Administration [Internet]. Centers for Disease Control and Prevention; [cited 2025 May 28]. Available from: https://www.cdc.gov/hepatitis-a/hcp/vaccine-administration/index.html 
6. Centers for Disease Control and Prevention. Hepatitis A Vaccine [Internet]. Centers for Disease Control and Prevention; [cited 2025 May 28]. Available from: https://www.cdc.gov/hepatitis-a/vaccination/index.html 
7. Mileno M, Lau C, Lonks J, Garland J, Sanchez M, Nau G, Larkin J. Vaccines for Adult Travelers. In: Keystone JS, Kozarsky PE, Freedman DO, Nothdurft HD, Connor BA, editors. Travel Medicine. 4th ed. Elsevier; 2019. Available from: https://www.researchgate.net/publication/330054961_Vaccines_for_Adult_Travelers 
8. Centers for Disease Control and Prevention. Travelers’ Health [Internet]. Centers for Disease Control and Prevention; [cited 2025 May 28]. Available from: https://wwwnc.cdc.gov/travel/page/travel-vaccines 
9. Herzog C, Van Herck K, Van Damme P. Hepatitis A vaccination and its immunological and epidemiological long-term effects – a review of the evidence. Hum Vaccin Immunother. 2021 May 4;17(5):1496-1519. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8078665/ 
10. Centers for Disease Control and Prevention. Possible Side Effects from Vaccines [Internet]. Centers for Disease Control and Prevention; [cited 2025 May 28]. Available from: https://www.cdc.gov/vaccines/basics/possible-side-effects.html 
11. Centers for Disease Control and Prevention. Guidelines for Vaccinating Pregnant Women [Internet]. Centers for Disease Control and Prevention; [cited 2025 May 28]. Available from: https://www.cdc.gov/vaccines-pregnancy/hcp/vaccination-guidelines/index.html
12. Rao IS, Kasi SG, Dhir SK, et al. Indian Academy of Pediatrics (IAP) Advisory Committee on Vaccines and Immunization Practices (ACVIP): Recommended Immunization Schedule (2023) and Update on Immunization for Children Aged 0 Through 18 Years. Indian Pediatr. 2024 Jan 15 [cited 2025 Oct 8]. Available from: https://indianpediatrics.net/epub012024/FTA-00592.pdf
13. National Health Mission. National Immunization Schedule. Ministry of Health and Family Welfare, Government of India; 2018. Available from: https://nhm.gov.in/New_Updates_2018/NHM_Components/Immunization/report/National_%20Immunization_Schedule.pdf
14. Anand AC, Roy A. Hepatitis A: A wake-up call! Indian J Gastroenterol. 2025 Jun 19;44(5):581–4. doi: 10.1007/s12664-025-01803-6. Available from: https://link.springer.com/article/10.1007/s12664-025-01803-6
15. Abimbola TO, Van Handel M, Tie Y, Ouyang L, Nelson N, Weiser J. Cost-effectiveness of expanded hepatitis A vaccination among adults with diagnosed HIV, United States. PLoS One. 2023 Mar 17;18(3):e0282972. doi: 10.1371/journal.pone.0282972. PMID: 36930611; PMCID: PMC10022807. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC10022807/
16. Nelson NP, Murphy TV, McMahon BJ. Hepatitis A vaccination for post-exposure prophylaxis in persons aged 40 years and older. Vaccine. 2014 May 23;32(25):2939. doi: 10.1016/j.vaccine.2014.01.086. Epub 2014 Feb 13. PMID: 24530928; PMCID: PMC4643264. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC4643264/

Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.

Links and product recommendations in the information provided here are advertisements of third-party products available on the website. PharmEasy does not make any representation on the accuracy or suitability of such products/services. Advertisements do not influence the editorial decisions or content. The information in this blog is subject to change without notice. The authors and administrators reserve the right to modify, add, or remove content without notification. It is your responsibility to review this disclaimer regularly for any changes.