Hepatitis Vaccinations: Who Should Get Them and Why?

Though hepatitis is rare, anyone who's had the disease knows that it’s a challenging diagnosis to cope with. The symptoms of fever, fatigue, stomach pain, dark urine, nausea and the yellowing of the skin and eyes, known as jaundice, can last for several weeks or even months. Some people even develop a chronic form of the disease, which can ultimately lead to cirrhosis and liver failure.

Preventing hepatitis

Fortunately, it’s easy to prevent the spread of hepatitis by taking a few basic precautions, such as avoiding unprotected sex and not sharing needles, razors or other personal items with anyone who is infected. And when it comes to hepatitis A and B, there’s an even easier way to prevent the spread of the illness, especially to infants who are unable to help themselves. That’s with vaccines that protect against the infections.

Vaccinating against hepatitis A

Of the hepatitis types that are prevalent in the United States (A, B and C), hepatitis A is the rarest. The American Academy of Pediatrics (AAP) estimates that about 1,500 people get infected with the virus each year. It’s also the least likely of the three types to lead to a chronic, lifelong infection.

Despite this, the symptoms of hepatitis A can be severe and long-lasting, usually lasting from two to seven weeks. And though it’s rare, hepatitis A can sometimes lead to severe complications, such as liver failure.

The hepatitis A vaccine is made up of inactive hepatitis A virus. For the vaccine to be effective at preventing the illness, it must be given in two doses that are spaced at least six months apart. For children, these two vaccinations are typically given when a child is 1 to 2 years old, as part of their regular vaccination regimen, according to the AAP.

Adults who are at risk of getting hepatitis A because of travel, sexual partners, illegal drug use, healthcare work or exposure to others with the disease may want to get the vaccine for protection. In addition, people who already have chronic hepatitis B or C may choose to get the hepatitis A vaccine to protect themselves from additional liver damage.

Some people, however, should not get the hepatitis A vaccine, such as those with allergies or a current illness. There are also some side effects related to the vaccination, such as a mild fever, fatigue, headache, soreness or redness at the spot where the vaccine was given, although these are rare reactions.

Historically, vaccinating for hepatitis A has been a major public health success story. When the vaccine was first recommended for widespread use in 1996, there were about 31,000 cases of hepatitis A each year in the United States. Since then, that number has dropped to about 1,500 cases a year, according to the AAP.

Vaccinating against hepatitis B

Like hepatitis A, hepatitis B can be an acute infection. It causes similar symptoms to hepatitis A that typically resolve on their own after a few weeks or months. But unlike hepatitis A, hepatitis B is more likely to lead to a chronic, or lifelong, infection. The National Institutes of Health (NIH) estimates that about 5 percent of hepatitis B cases in adults will become chronic. But among children 1 to 5 years old, that number is 25 to 50 percent, and it’s close to 90 percent in babies.

Also, once hepatitis B becomes chronic, there often isn’t a cure for it. There are costly antiviral medications that can keep the illness in check, but it typically doesn’t resolve completely. Some people with chronic hepatitis B may require a liver transplant at some point in their lives.

That's one of the reasons that vaccinating for hepatitis B is a critically important step for public health. The NIH notes that the vaccine is given in three separate doses over the course of six months. All infants and children should receive the vaccine as part of their regular vaccination regimen.

Others may want to consider getting the hepatitis B vaccine, as well. For example, people who are traveling to regions of the world where hepatitis B is common may want to consider getting all three doses of the vaccine before they go. And if you think you may have come in contact with hepatitis B, your doctor can give the vaccine along with a drug called hepatitis B immune globulin (HBIG) to potentially kill the virus before the infection can even get started.

Combination vaccine

For infants, both hepatitis A and B vaccines are recommended and should be part of children's regular vaccination regimen.

For adults at risk, there's a combination hepatitis A and B vaccine that can take care of both strains of the virus with one drug, according to the Mayor Clinic. People who may want to consider a combination vaccination include those who may be putting themselves at risk for hepatitis exposure due to travel abroad, healthcare work, participation in the military, sexual orientation or living with someone with hepatitis.

The vaccine, sold as Twinrix, is typically administered in three doses over the course of six months. The medication is currently recommended only for adults as the safety of the vaccine for children has not been established.

Vaccine news for other forms of hepatitis

With all this talk about vaccination for hepatitis, you may be wondering about the most common form of hepatitis in the United States, hepatitis C. With 30,000 new infections a year and more than 3 million people with the disease overall, according to the U.S. Centers for Disease Control (CDC) estimates, it would seem to be the best candidate for a vaccine. What’s more, 75 to 85 percent of the people who are exposed to the hepatitis C virus end up developing chronic hepatitis C.

However, though research is ongoing, the NIH notes that there is currently no approved vaccine for hepatitis C. According to the Mayo Clinic, efforts to develop a hepatitis C vaccine have been ongoing for more than 25 years, and a few options have shown some promise. The high variability of the different hepatitis C genotypes has made it more challenging to develop than the other hepatitis vaccines.

When it comes to the rarer forms of hepatitis, hepatitis D can only occur in people who also have hepatitis B, so the vaccine for hepatitis B can cover that possibility. And hepatitis E does have a viable vaccine, but it’s currently only available in China.

The bottom line

In the last few decades, vaccinations have become an incredibly important medical tool in the prevention of hepatitis, particularly A and B. As the AAP has noted, cases of hepatitis A in the United States have dropped by almost 30,000 a year thanks to the advent of the vaccine in 1996. Hepatitis B vaccine can not only prevent hepatitis B, but it may also prevent chronic hepatitis infection after exposure to the virus. Health experts hope that continuing research will lead to a viable vaccine for hepatitis C in the not too distant future.