hepatitis a vaccine (inactivated, adsorbed): clinical use

Prescribing considerations

• Base use on current official recommendations and individual exposure, transmission and severe-disease risk.
• Protection is not immediate and may be incomplete, particularly with immune suppression or unrecognised incubating infection.
• Consider previous-immunity testing when past infection is likely.
• Assess bleeding risk before intramuscular administration and follow product-specific route guidance.
• Record the product name and batch number for traceability.

Contraindications and cautions

• Hypersensitivity to the active substance or an excipient, or a serious hypersensitivity reaction after a previous relevant injection.
• Relevant product-specific allergies include neomycin; VAQTA may also contain trace formaldehyde.
• Postpone vaccination during an acute severe febrile illness.
• Use caution with VAQTA single-dose vials in latex-sensitive people because the stopper contains natural latex.
• AVAXIM Junior contains phenylalanine and requires consideration in phenylketonuria.

Monitoring

• Ensure facilities and trained staff are available to manage anaphylaxis.
• Routine post-vaccination antibody testing is generally unnecessary but may be considered when impaired immunity could produce an inadequate response.
• Observe people prone to fainting and take precautions to prevent injury.
• Report suspected adverse reactions through the MHRA Yellow Card scheme.

Clinical pharmacology

These are inactivated whole-virus vaccines produced in human diploid cells and adsorbed onto an aluminium-containing adjuvant. They induce active anti-HAV antibody responses without containing replicating virus.

Formulation and product differences

• VAQTA Adult and Paediatric contain the CR 326F strain adsorbed onto amorphous aluminium hydroxyphosphate sulfate; presentations include pre-filled syringes and vials.
• VAQTA may contain trace neomycin and formaldehyde; its single-dose vial stopper contains natural latex.
• AVAXIM Junior contains the GBM strain adsorbed onto hydrated aluminium hydroxide and is supplied in a pre-filled syringe.
• AVAXIM Junior may contain trace neomycin and contains phenylalanine and a small quantity of ethanol.
• The monovalent products use different manufacturer-specific antigen units, so their numerical strengths should not be directly compared.