Hepatitis A vaccination: who needs it, doses and how long it lasts

Hepatitis A is a liver infection caused by a virus that spreads in the poo of an infected person. The NHS says most people who get it get better within a few months, and that it is not common in the UK but is common in other parts of the world, including parts of Africa, Asia, the Middle East and Central and South America.

You can catch it by drinking unclean water, eating food that has been washed or grown in unclean water, eating food handled by an infected person, or through close physical contact with an infected person, including sex and sharing needles. TravelHealthPro adds that hepatitis A is rare in the UK, with most cases occurring in travellers who have recently visited countries where the disease is common. The UK Health Security Agency describes the disease as generally mild, but says severity tends to increase with age.

Symptoms can include a high temperature, flu-like symptoms, feeling or being sick, upper tummy pain, diarrhoea or constipation, pale poo, dark pee, itchy skin and jaundice, according to the NHS. Most children and some adults have mild symptoms or none at all. The infection usually clears on its own within 3 to 6 months, and a person is usually infectious for 7 days after jaundice or symptoms began.

The NHS calls vaccination the best way to prevent hepatitis A, and sets out who should consider it. TravelHealthPro lists the travellers at increased risk.

TravelHealthPro lists several inactivated hepatitis A vaccines available to travellers and explains the schedules. For adults, most single hepatitis A vaccines, such as Avaxim, Havrix Monodose and Vaqta, are 2 doses given 6 to 12 months apart (Vaqta Adult for those 18 and over). Children aged 1 to 15 or 17 have junior vaccines, with doses 6 to 36 months apart depending on the product.

Combined products exist. Twinrix, which protects against hepatitis A and B, is 3 doses at 0, 1 and 6 months, or an accelerated schedule of days 0, 7 and 21 with a fourth dose at 12 months. Combined hepatitis A and typhoid vaccines are 1 dose followed by a single-antigen hepatitis A vaccine 6 to 12 months later.

You can ask about timing with a travel clinic, GP, nurse or pharmacist; the NHS recommends getting advice from one of these before you go abroad.

According to TravelHealthPro, the duration of protection from a completed course of hepatitis A vaccine can be expected to be at least 25 years and probably indefinite. However, the UK Health Security Agency recommends that, until further evidence is available on how long immunity persists, a booster dose at 25 years is indicated for those at ongoing risk of hepatitis A.

People with altered immune responses may be advised to have an earlier booster, so specific advice should be sought. TravelHealthPro also notes that after a hepatitis A illness immunity is lifelong, so people who have had the infection do not need the vaccine.

Vaccination is not a substitute for hygiene precautions. The NHS says you can also reduce risk when travelling by washing your hands thoroughly before preparing and eating food and after using the toilet, drinking bottled water, and avoiding shellfish and uncooked fruit and vegetables.

The NHS says to see a GP if you have symptoms and have recently travelled to a country where hepatitis A is common, have been in close contact with someone who has it, have a blood clotting disorder, or are in another risk group. Tell the GP you think you might have hepatitis A.

Ask for an urgent GP appointment or get help from NHS 111 if you think you might have it and you are pregnant, aged over 60 or have a liver condition. The NHS advises limiting contact with other people for 7 days after symptoms or jaundice started, and not preparing food or drink for others while infectious.

The NHS says to speak to your GP if you think you need a hepatitis A vaccine, and that your employer should organise vaccination if your job puts you at risk. For travel, the NHS says you may need to pay, so many people have the vaccine at a travel clinic or a pharmacy with a travel health service, often paying privately.

Because the second dose is given months after the first, it helps to start well before departure and to keep a record of dates. A provider can tell you which brand they use and whether a combined hepatitis A and B or typhoid product is appropriate for your plans.