Per Wikipedia:  “Hepatitis A is an infectious disease of the liver caused by the hepatitis A virus (HAV). Many cases have few or no symptoms, especially in the young. The time between infection and symptoms, in those who develop them, is between two and six weeks. When symptoms occur, they typically last eight weeks and may include nausea, vomiting, diarrhea, jaundice, fever, and abdominal pain. Around 10–15% of people experience a recurrence of symptoms during the six months after the initial infection. Acute liver failure may rarely occur, with this being more common in the elderly.

“It is usually spread by eating food or drinking water contaminated with infected feces. Shellfish which have not been sufficiently cooked are a relatively common source. It may also be spread through close contact with an infectious person. While children often do not have symptoms when infected, they are still able to infect others. After a single infection, a person is immune for the rest of his or her life. Diagnosis requires blood testing, as the symptoms are similar to those of a number of other diseases.”

According to the CDC, prior to the release of the hepatitis A vaccine there were approximately 30,000 cases of hepatitis A in the US annually.  Recent figures are closer to 2000 annually.  Hepatitis A is very rarely fatal, usually only in those with existing liver disease.  According to the CDC, the vaccine is effective for approximately 20 years.

Vaccine Statistics

When debating informed consent, it is important that people calculate the risk versus the reward for all options.  Here are some facts, according to VAERS and the CDC.

  • Since 2000, there have been no child deaths from hepatitis A in the US.  Hepatitis is almost always asymptomatic or mild in children.
  • Since 2000, there have been at least 8 deaths reported to VAERS associated with the hepatitis A vaccine.
  • Since 2000, there have been 2512 adverse events reported to VAERS, with the vast majority of them in adults.

With no other data, it is clear that children in the US face a greater risk of death from the hepatitis A vaccine than they do from hepatitis A, though the risks in either case are negligible.  In terms of risk of the disease, an individual has less than a 1 in 160,000 chance of contracting it in any given year in the US.  Other statistics from VAERS (since 2000):

  • 39 life threatening complications
  • 63 permanent disabilities
  • 182 hospitalizations or extensions of hospitalization
  • 852 emergency room visits

It is fair to point out that the vast majority of these events occur in adults.  In terms of the vaccine itself, it, like the disease itself, is reasonably benign.  The biggest risk from the vaccine is the high dose of aluminum used as an adjuvant.

Vaccine Safety

Vaccine Typedead cell/fully immune

Pregnancy ClassC (Havrix)

This section will reference the product insert for Havrix as provided by the FDA.  The hepatitis A vaccine uses high levels of aluminum adjuvants.

Contraindications (do not vaccinate):

  • Allergy to latex or any component of the hepatitis A vaccine
  • Under one year of age

Adverse Reactions (as reported by the manufacturer):

  • Injection site soreness/redness/swelling/induration, headache, anorexia, nausea, fatigue, malaise, pharyngitis, upper respiratory infection, lymphadenopathy, insomnia, dysgeusia, hypertonia, photophobia, vertigo, abdominal pain, diarrhea, vomiting, pruritis, rash, urticaria, arthralgia, myalgia, reduced kidney function, rhinitis, thrombocytopenia, anaphylaxis, convulsion, dizziness, encephalopathy, Guillain-Barré syndrome, hypoesthesia, multiple sclerosis, myelitis, neuropathy, paresthesia, somnolence, syncope, vasculitis, dyspnea, hepatitis, jaundice, angioedema, erythema multiforme, hyperhidrosis, musculoskeletal stiffness, influenza-like symptoms

Editor’s Opinion

In children, hepatitis A is generally benign as far as diseases go.  In adults the disease can range from an uncomfortable long-lasting condition to fatal in rare cases.  For adults and children traveling to areas where hepatitis A is endemic, we support the administration of the hepatitis A vaccine at least two weeks prior to traveling.  For children not traveling to areas where hepatitis A is endemic, we do not recommend its administration due to the use of aluminum adjuvants.  For teenagers and adults not traveling to areas where hepatitis A is endemic, we consider the risk versus reward profile a toss-up.