Hepatitis A

Hepatitis A is a viral disease that thrives in poor sanitation areas. It can spread when people consume something that has been contaminated with human body waste products. Children often show no symptoms, and the disease can be more serious in adults.  Hepatitis A does not cause chronic, long term infection and death is rare.  Infection with hepatitis A gives a person lifelong immunity and it has been shown that in some populations around the world, close to 100 percent of all inhabitants have natural antibodies to hepatitis A. 

HAV infection usually causes an abrupt onset of fever, malaise, loss of appetite, nausea and abdominal discomfort. These symptoms can be followed by jaundice (yellowing of the skin and white of the eyes) within a few days. Not everyone infected with hepatitis A becomes jaundiced and children often do not have any symptoms of infection.

 
 
 
 
 

 

The CDC Pink Book  information on Hepatitis A-  

 

The likelihood of symptomatic illness from HAV infection is directly related to age. In children younger than 6 years of age, most (70%) infections are asymptomatic. In older children and adults, infection is usually symptomatic, with jaundice occurring in more than 70% of patients.

 

The package inserts  for Havrix, Twinrix and Vaqta.  Natural immunity occurs with having the disease but the vaccine does not provide the same. The efficacy of hepatitis A vaccines in early childhood is unknown.  SmithKline Beecham states: 

At present the duration of protection afforded [by HAVRIX] has not been established. Therefore it is unknown if the protection provided to immunized children will last until adulthood.”

Here’s an interesting report:

 

 “Infection with the hepatitis A virus may provide some protection against asthma and allergies, but only in people with a common form of a gene important in the immune system, a new study finds.  
 
“But while hepatitis A was an unpleasant infection — causing few or no symptoms in young children but jaundice, nausea, diarrhea and other complaints in adults — contact with the virus seems to help the immune system mature. One piece of circumstantial evidence is that hepatitis A rates have fallen in the West while allergy rates have soared, doubling in the last two decades alone.  
 

In 2005, Merck gained FDA approval to lower the age indication of their existing Hepatitis A vaccine (VAQTA) from 2 years of age to 12 months. HAVRIX soon followed.


Years ago only a handful of states mandated Hepatitis A for school entry, but once the age level was lowered for the vaccines, more states have begun to mandate it.

 

States that have had the highest incidence of hepatitis A:

  • Alaska
  • Arizona
  • California
  • Idaho
  • Nevada
  • New Mexico
  • Oklahoma
  • Oregon
  • South Dakota
  • Utah
  • Washington

The best tool for prevention of hepatitis A is to wash your hands with soap and water after using the bathroom, changing a diaper or preparing and eating food. It’s just common sense!

 
Hepatitis A Vaccine Can Cause Reactions:

 

 In clinical trials conducted by SmithKline Beecham, between 9 and 14 percent of adults and children reported headache after vaccination and between 21 and 56 percent had local reactions. Up to 10 percent had fever, fatigue, malaise, nausea and loss of appetite. Other reported reactions included stomach pain, diarrhea, vomiting, and joint pain. Post marketing vaccine reaction reports have included anaphylaxis, jaundice, convulsions, multiple sclerosis, Guillain-Barre syndrome, and neuropathy.

 

Since the vaccine was licensed in 1996, there have been nearly 3,000 reports of hepatitis A vaccine related adverse events made to the government (VAERS), including serious events and deaths.
  • Vaccine Components Not Adequately Evaluated:
 
Hepatitis A vaccines manufactured by SmithKline Beecham and Merck are made using human fetal diploid (lung) cells to propagate the virus. HAVRIX contains aluminum as well as phenoxyethanol as a preservative. Traces of formalin and residual fetal human diploid cellular proteins are also present. VAQTA contains aluminum and small amounts of non-viral protein, DNA, bovine albumin, and formaldehyde.  Both HAVRIX and VAQTA have “not been evaluated for its carcinogenic or mutagenic potential, or its potential to impair fertility.”
  •  No Long Term Studies:

 There were no long term studies to evaluate whether hepatitis A vaccine given alone or in combination with other vaccines is associated with chronic illness or disability, such as the development of diabetes, asthma, seizure disorders, learning disabilities, ADHD, or autism. The Merck product insert for VAQTA states:

 “Subjects were observed during a 5-day period for fever and local complaints and during a 14-day period for systemic complaints.”

  • References:
    1. CDC Hepatitis A Fact Sheet www.cdc.gov/ncidod/diseases/hepatitis/a/fact.htm
    2. WHO Position Paper on Hepatitis A Vaccines: Weekly Epidemiological Record, No. 5. Feb. 4, 2000.
    3. Immunization Requirements www.sabin.org/map.htm
    4. SmithKline Beecham Product Manufacturer Insert (Hepatitis A Vaccine, Inactivated (HAVRIX). From Physicians Desk Reference (PDR), 2001.
    5. Merck Product Manufacturer Insert (Hepatitis A Vaccine, Inactivated (VAQTA). Issued March 2001.
    6. CDC. Prevention of Hepatitis A Through Active or Passive Immunization. Recommendations of the ACIP. MMWR. Dec. 27, 1996: Vol. 45, No. RR-15.
    7. Selected notifiable disease rates: United States, 1950-99 http://www.cdc.gov/nchs/products/pub…1/01hus052.pdf
    8. Vaccine Adverse Event Reporting System (VAERS) Report data
    9. Associated Press press report: More Hepatitis Vaccinations Urged. Dec. 18, 2001.

 

Source: Risk factors associated with reported hepatitis A, 1990-2000, United States.
Notes: From 1990 through 2000, the most frequently reported source of infection was personal contact (household or sex) with an infected person (14%). Two percent of cases involved a child or employee in day-care; 6% of cases were a contact of a child or employee in day-care; 5% of cases reported recent international travel; and 4% of cases reported being part of a recognized foodborne outbreak. Injection drug use was a reported risk factor in 6% of cases; men who have sex with men represented 10% of cases. Forty-six percent of reported hepatitis A cases could not identify a risk factor for their infection. (Risk factor percentages rounded to nearest percent.)
Adapted from: Centers for Disease Control and Prevention, Division of Viral Hepatitis. 
http://www.cdc.gov/ncidod/diseases/hepatitis/slideset/hep_a/slide_18.htm

 

 

 
 
 
 
 

 

 

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