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Those with Hepatitis B or C Need Hepatitis A Immunity

Nicole Cutler L.Ac. May 16, 2011

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To prevent the serious danger Hepatitis A poses to those with preexisting chronic liver disease, immunity through previous illness or vaccination is an absolute necessity.

Individuals who currently have chronic Hepatitis B or chronic Hepatitis C are urged to get vaccinated against Hepatitis A if they haven’t already gained immunity. However, there are several reasons someone with one of these chronic liver viruses may not fully consider this directive. While certain vaccinations are voluntary and surrounded by controversy, the Hepatitis A inoculation should be mandatory to those who have never before had the illness – especially for anyone with a chronic virus in his or her liver.

For individuals with chronic liver disease, there are several reasons that a doctor’s advice to receive the Hepatitis A vaccine could be passed over. For starters, the lifestyle adjustments suggested to those with liver concerns can feel like a seemingly endless stream of unrealistic, über-healthy aspirations. Between deciding on liver disease treatment, evaluating everything that is consumed, eliminating vices like smoking and drinking, carefully choosing detergents and body care products and being aware of inhaling pollutants, making plans to get vaccinated can seem like the bottom of the totem pole.

Vaccination Qualms

To compound the lackadaisical attitude some people have toward the Hepatitis A vaccine, debate seems to hound modern day vaccination recommendations. Since they have been a part of modern medicine’s arsenal, the morality, efficacy and safety of vaccinations has been under fire. In addition, some conspiracy theorists argue that these costly medications exist primarily to benefit the pocket of the pharmaceutical companies. Regardless of the legitimacy of these doubts and accusations, not all vaccines are in this dubious position. When it comes to the Hepatitis A vaccination, there is little resistance to this lifesaver.

Hepatitis A

Hepatitis A is a viral infection of the liver that is acquired through contact with an infected person’s stool. Hepatitis A infection most commonly occurs from:

  • eating food made by an infected person who didn’t wash his or her hands after using the bathroom
  • drinking untreated water or eating food washed in untreated water
  • placing a finger or object in your mouth that came into contact with an infected person’s stool
  • having close personal contact with an infected person, such as through sex or caring for someone who is ill

In healthy individuals, Hepatitis A causes an acute illness with fever, loss of appetite, fatigue, diarrhea, stomach pain and jaundice lasting two to three weeks. Complete recovery is the rule, followed by life-long immunity to the virus. However, in those with preexisting liver disease like chronic Hepatitis B or C, acute Hepatitis A tends to be severe and can be fatal.

Hepatitis A Vaccine

For those who do not yet have immunity, vaccination with the Hepatitis A vaccine is the best way to prevent Hepatitis A infection. Given through two shots, the second shot given 6 to 12 months after the first, both are needed to be fully protected from the Hepatitis A virus. With extremely high marks for safety and efficacy, the side effects of the Hepatitis A vaccine are considered to be relatively mild. Among adults, the most frequently reported side effects are soreness at the site of the injection and headache. In children, the most frequently reported side effect is soreness at the injection site.

Those who should not get the Hepatitis A vaccine or who have justifiable reasons to be concerned about receiving it, include:

  • Anyone who has ever had a severe allergic reaction to a previous dose of Hepatitis A vaccine.
  • Anyone who has a severe allergy to any vaccine component. All Hepatitis A vaccines contain alum and some contain 2-phenoxyethanol.
  • Anyone who is moderately or severely ill at the time the shot is scheduled should probably wait until he or she recovers.
  • People with a mild illness can usually get the vaccine.
  • The safety of the Hepatitis A vaccine has not been determined for pregnant women. There is no evidence that it is harmful to either pregnant women or their unborn babies; thus the risk, if any, is thought to be very low.

Those at Great Risk of Being Harmed by Hepatitis A

In healthy individuals, Hepatitis A is a self-limiting illness without any long-term effects. However, those with chronic liver disease, like chronic Hepatitis B or C, are at risk of serious harm from Hepatitis A infection. As published in the October 1999 edition of the Annals of Tropical Medicine and Parisitology, researchers found Hepatitis A to be severe and potentially fatal in patients with underlying chronic Hepatitis B or Hepatitis C. They concluded that these individuals should be candidates for receiving the Hepatitis A vaccine if they don’t already have immunity to it. Since then, several more studies have come to the same conclusion, cementing the recommendations that those with chronic liver disease be immunized against Hepatitis A.

Although scheduling the two shots constituting the Hepatitis A vaccine may seem like an unnecessary chore, those with chronic Hepatitis B or C are urged to change their perception of this vaccination. Since it can easily progress to a dangerous or fatal outcome, anyone with chronic liver disease owes it to themselves to prioritize gaining immunity to the Hepatitis A virus.

References:

http://digestive.niddk.nih.gov/ddiseases/pubs/hepa_ez/, What I Need to Know About Hepatitis A, Retrieved May 6, 2011, National Digestive Diseases Information Clearinghouse, 2011.

http://www.cdc.gov/vaccines/Pubs/vis/downloads/vis-hep-a.pdf, Hepatitis A Vaccine, Retrieved March 5, 2011, Department of Health and Human Services, 2011.

http://www.immunize.org/askexperts/experts_hepa.asp, Ask the Experts: Hepatitis A, Retrieved March 6, 2011, Immunization Action Coalition, 2011.

http://www.medscape.com/viewarticle/472653_2, Hepatitis A Super-Infection in Chronic Liver Disease, G.Reiss, E.B. Keeffe, Retrieved March 5, 2011, WebMD LLC, 2011.

http://www.ncbi.nlm.nih.gov/pubmed/10715703, Acute, hepatitis-A super-infection in HBV carriers, or chronic liver disease related to HBV or HCV, Pramoolsinsap C, et al, Retrieved March 5, 2011, Annals of Tropical Medicine and Parisitology, October 1999.

http://www.ucsfhealth.org/conditions/viral_hepatitis/, Viral Hepatitis, Retrieved March 5, 2011, The Regents of the University of California, 2011.

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