People aged ≥1 year who travel to moderately to highly endemic areas for hepatitis A are recommended to receive hepatitis A vaccine
People aged ≥1 year are recommended to receive hepatitis A vaccine if they travel to moderately to highly endemic areas for hepatitis A.6 This includes expatriates, and people who are visiting friends and relatives.
1 dose of a monovalent hepatitis A vaccine provides protective levels of antibodies against hepatitis A virus.7 A 2nd dose is recommended 6–12 months after the 1st dose, to increase the duration of protection.
If the person travelling is also at risk of acquiring hepatitis B, they can receive a combination hepatitis A/hepatitis B vaccine. This is usually given in 3 doses. Travellers aged 1 to <16 years can receive a 2-dose schedule using Twinrix 720/20 (minimum 6 months interval between doses).
Travellers aged ≥16 years can receive hepatitis A/hepatitis B vaccine in a ‘rapid’ schedule if there is limited time before departure.8 This consists of a single dose on each of:
- day 0
- day 7
- day 21
- 12 months
The 4th dose is important to ensure longer-term protection.
For more details, see Hepatitis B.
The combination hepatitis A/typhoid vaccine is an option for people ≥16 years of age who are travelling to countries where there is an increased risk of both these diseases. This combination is particularly useful for people who are already immunised against hepatitis B.
To provide longer-term protection against hepatitis A in travellers who are receiving a combination hepatitis A/typhoid vaccine:
- give 1 dose of combination hepatitis A/typhoid vaccine
- at a minimum of 6 months later, give 1 dose of a monovalent adult formulation hepatitis A vaccine
A person who received a previous dose of a monovalent adult formulation hepatitis A vaccine can receive a combination hepatitis A/typhoid vaccine as a booster dose. They should receive the combination vaccine at least 6 months after the 1st dose of hepatitis A vaccine.
For more details, see Typhoid fever.