The HepUpdate series is comprised of original papers reflecting the views of each of each of the contributing specialists. This area is currently very topical, with the recent development of an effective vaccine against hepatitis A, and the implementation plans of almost all provinces and territories for universal hepatitis B vaccination. In this article, the most frequently posed questions concerning immunoprophylaxis against viral hepatitis will be addressed. The first dose of the vaccine probably requires at least three weeks to induce significant antibodies, so those travellers who did not have the foresight to have the first dose administered at least three weeks before departure to a high-endemic area should also have standard gammaglobulin to assure protection.
Protective antibody titres to the vaccine last at least three years.
At this time the need for booster doses is unclear, but it's likely that, similar to hepatitis B, they will be unnecessary. The vaccine should be administered as an IM injection into the deltoid. Development of highly effective hepatitis A vaccines has obviated the need for gammaglobulin. This refers to vaccination of the entire population, usually at the neonatal or childhood level. The rationale for this is that targeted vaccination of high-risk groups has failed to achieve its aims, because most people in these risk groups are unaware or unwilling to be vaccinated.