Havrix Junior is approved for use for children from 1 year of age and adolescents to 16 years of age.

Havrix 1440 is approved for use for adolescents from 16 years of age and adults.

Havrix is not given as part of the routine immunisation schedule.

Special groups

Havrix is recommended and funded for:

• Transplant recipients (two doses)
• Children with chronic liver disease (two doses)
• Close contacts of a hepatitis A case (one dose)

Havrix is also recommended but not funded for certain occupations at risk of exposure to faeces or involved in food preparation:

• Early childhood employees
• Carers of people with developmental disabilities
• Healthcare staff, including cleaners
• Sex industry workers
• People exposed to sewerage

Additionally, the vaccine is recommended for:

• Correctional facility inmates
• Men who have sex with men
• Injecting drug users
• Recipients of blood products, such as factor VIII

Storage and preparation

No special considerations, store as per cold chain between 2°C to 8°C.

Administration

Havrix is given as a single dose of vaccine administered by intramuscular injection for children and adults. A second vaccination 6-12 months later acts as a booster vaccination to extend the duration of protection.

It can be administered concurrently with other vaccines, including all the National Immunisation Schedule vaccines. Separate syringes and different injection sites should be used.

The vaccine can be administered at the same visit, using a different injection site, as immunoglobulin (Ig) for persons requiring hepatitis A vaccination for post-exposure prophylaxis.

Persons having haemodialysis or who are immune suppressed may need additional vaccine doses to develop protection against the disease.

Havrix vaccines should not be given to:

• Anyone with severe allergy (anaphylaxis) to a previous dose of this vaccine or other hepatitis A-containing vaccine, or a component of the vaccine
• Administration of Havrix should be postponed in individuals suffering from a fever over 38°C. The presence of a minor infection is not a reason to delay immunisation

The vaccine can be administered to pregnant and breastfeeding women at high risk of the disease e.g. travelling to a hepatitis A endemic area or a close contact of a hepatitis A case.

Havrix has not been clinically designed for administration subcutaneously in persons at risk of haemorrhage following intramuscular injections. The alternative vaccine Avaxim, can be administered subcutaneously.

A serology result of ≥20 mIU/mL is considered to demonstrate immunity to hepatitis A.

Immunisation against hepatitis A protects 9-10 out of 10 people against the disease. Clinical trials indicated that after the second dose, protection lasts for at least 17 years, possibly up to 30-40 years. A recent review concluded that protective antibody levels to hepatitis A could be present for at least 25 year in adults and at least 14-20 years in children following a two dose course of vaccine.

In clinical trials, 15 days after vaccination 88% of healthy vaccine recipients aged 16–50 years and 93% aged 1–16 years were protected against hepatitis A. One month after vaccination 99% of healthy recipients aged 1—50 years were protected against the disease.

• Centers for Disease Control and Protection. Hepatitis A Questions and Answers for Health Professionals; [revised 2020 July 28, accessed 2020 September 28] Available from: https://www.cdc.gov/hepatitis-a/hcp/clinical-overview/?CDC_AAref_Val=https://www.cdc.gov/hepatitis/hav/havfaq.htm
• Hens N et al. Model based estimates of long-term persistence of inactivated hepatitis A vaccine-induced antibodies in adults. Vaccine 2014 14 (32)1507-13.
• Health New Zealand | Te Whatu Ora, Immunisation handbook [Internet]. Available from: https://www.tewhatuora.govt.nz/for-health-professionals/clinical-guidance/immunisation-handbook