Hepatitis a vaccinationZ24.6

Good personal hygiene helps to prevent the faecal-oral transmission of hepatitis A. Protective measures are recommended, but isolation of the patient is of little help. Contaminated surfaces around the patient can be cleaned with virucidal disinfectants.

The Hepatitis A vaccine is recommended for all children starting at age 1, with a second dose 6 to 18 months after the first.

A pre-exposure HAV vaccination should be provided for:

• travelers with high or moderate HAV endemicity. Indications for travel are: "south of the Alps and east of the Oder".
• Diagnostic laboratory workers
• Men who have sex with men
• People who use illegal drugs with or without injections
• People with chronic liver disease (including chronic hepatitis C) because they are at increased risk of developing fulminant hepatitis due to HAV.
• People who receive coagulation factor concentrates
• Pre-exposure HAV prophylaxis can be considered for kindergarten employees.

Notes:

• HAV vaccines are safe and provide protection within about 4 weeks and also have a long-term protective effect (probably > 20 years).
• For basic immunization with monovalent hepatitis A vaccine 2 doses at intervals of 6-12 months are necessary. Depending on the manufacturer, booster vaccinations are only necessary after 20-30 years after basic immunisation.
• Elderly travellers without vaccination protection who have received a hepatitis A vaccination ≥ 2 weeks before travelling to endemic areas should receive standard immunoglobulins.
• Post-exposure prophylaxis should be given to family members and close contacts of patients with hepatitis A
• In patients > 75 years (see also Frailty syndrome ) with chronic liver disease and patients with weakened immune system, a standard immunoglobulin prevents hepatitis A infection or reduces the severity of the disease (dosage: 0.02 ml/kg i.m.). The immunoglobulins can be given up to 2 weeks after exposure.