The vaccine, called Havrix or VAQTA, is made from inactivated whole virus of hepatitis A. It is given by an injection in your arm. You should be protected against the disease within two weeks after receiving the first injection.

To ensure complete immunization against the disease, two vaccinations are required. After receiving the first vaccination, children and adults should have a booster vaccination in six to 12 months.

There is also a vaccine for adults called Twinrix that contains both Hepatitis A and B in combination. It reduces the number of needle sticks to achieve immunity to both viruses. It is given in 3 doses.

WHO SHOULD BE IMMUNIZED

People who work or travel in areas with high rates of infection should be vaccinated. These areas include Africa, Asia (except Japan), the Mediterranean, Eastern Europe, the Middle East, Central and Southern America, Mexico, and parts of the Caribbean. See the Centers for Disease Control and Prevention website for specific travel destination information.

If you are traveling to these areas before you are fully immunized (less than 4 weeks after first immunization), you should receive a prophylactic does of immunoglobulin (IG). If you are just a short-term traveler to these areas, you may wish to only receive the immunoglobulin (IG) instead of the vaccine.

This vaccine is mandated in children in Alaska, Arizona, Missouri, Nevada, New Mexico, Oklahoma, Tennessee, Texas, and Utah. In addition, the ACIP recommends vaccination in children in California, Montana, Idaho, Oregon, and Washington. These recommendations are based on the indidence of Hepatitis in these states.

• Illicit intravenous drug users
• People who work with the hepatitis A virus in a laboratory or with primates that may be infected with the virus
• People who have chronic liver disease
• People who receive clotting factor concentrate to treat hemophilia or other clotting disorders.
• Military personnel
• Homosexual or bisexual men
• Employees of child day-care centers
• People who care for institutionalized patients

• People who have had hepatitis A in the past. Once you have recovered from the disease, you are immune for life.
• People who are allergic to the components of the vaccine.
• Children less than 2 years old.
• Pregnant or nursing mothers.
• If you are sick or have a fever, you should delay receiving the vaccine until you are feeling better.

RISKS

The possible complications are mild and rarely last longer than a day. The most common side effect of the vaccine is pain at the injection site. Other rare, but possible, side effects include:

• Redness, swelling, or bruising at the injection site
• Headache
• Fever
• Fatigue
• Muscle aches
• Nausea
• Loss of appetite

• You develop rash, itching, hives, or difficulty breathing after the injection.
• You develop any other symptoms after hepatitis A immunization.
• You have other questions or concerns about hepatitis A immunization.