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16 Jun 2017 - Global Shortage of Hepatitis A Vaccine and Dose Sparing Recommendations

The current global shortage of hepatitis A vaccine is ongoing and continues to affect the supply of hepatitis A containing vaccines in the United Kingdom. Consequently it has become necessary to consider options for hepatitis A dose sparing as some products may be unavailable or may need to be prioritised for special risk groups.

The following temporary guidance is approved by the Joint Committee on Vaccination and Immunisation (JCVI) for health professionals in the UK:

  • Hepatitis A vaccine use should be prioritised for high risk travellers; a thorough risk assessment will help ensure vaccine recommendations are appropriate.
  • If an adult monovalent hepatitis A vaccine is not available immunocompetent adults can be given a single priming dose of either paediatric monovalent hepatitis A or adult combination hepatitis A/B vaccine (off-label).
  • Non hepatitis A immune HIV positive people should preferentially receive standard adult antigen content monovalent hepatitis A as a priming dose due to the poorer response rates to vaccine in this group.
  • If an adult monovalent hepatitis A vaccine is not available then adults that have been primed with adult monovalent hepatitis A can be given a booster dose of either paediatric monovalent hepatitis A or adult combination hepatitis A/B vaccine (off-label).
  • Adults that have been primed with adult monovalent hepatitis A can have their booster dose delayed beyond the recommended 12 months, to five years, in most circumstances.

Unless working from an amended Patient Group DirectionLink health professionals that are not independent prescribers must use a Patient Specific DirectionLink to supply or administer products off-labelLink in addition to following any local guidelines, policy and procedures.

TRAVAX has produced a news item regarding hepatitis A vaccine for susceptible men including those who have sex with men (MSM travellers) attending Gay Pride in Madrid (23 June to 2 July 2017).

Public Health England has released guidanceLink on pre-exposure recommendations for hepatitis A vaccine.

The TRAVAX advice line is available between 14:00 - 16:00 on a Monday, 14:00 - 16:00 on a Wednesday and 09:30 - 11:30 on a Friday:

  • TRAVAX advice line 0141 300 1130

Further updates will be made as they become available.

Sources

  • Health Protection Scotland
  • Joint Committee on Vaccination and Immunisation
  • Public Health England
  • National Travel Health Network and Centre
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