II. Indications (otherwise administer Hepatitis A Vaccine)

  1. Preexposure Travel to endemic areas
    1. Travel within 1 month (otherwise use Vaccine)
    2. Age under 1 year or Vaccine otherwise contraindicated
  2. Postexposure (within 2 weeks of exposure)
    1. Household and institutional contacts
    2. Not necessary for casual work contacts

III. Epidemiology

  1. Most frequent Vaccine preventable disease in travelers

IV. Protocol

  1. Pre-exposure for travelers to endemic areas
    1. Travel <3 months
      1. Hepatitis A Immunoglobulin 0.02 ml/kg IM
    2. Travel Longer than 3 months (protective for 5 months)
      1. Hepatitis A Immunoglobulin 0.06 ml/kg IM q4 months
  2. Post-exposure (within 2 weeks)
    1. Hepatitis A Immunoglobulin 0.02 ml/kg IM

V. Preparation

  1. Immunoglobulin from pooled human plasma
  2. Considered safe from transmission of contagious disease
    1. Viruses inactivated
    2. Tested for Hepatitis B, Hepatitis C and HIV

VI. Contraindications

  1. IgA Deficiency
  2. Not contraindicated in pregnancy or Lactation

VII. Efficacy

  1. Pre-exposure before travel
    1. Prevents infection in up to 85%
  2. Post-exposure (if given within 2 weeks of exposure)
    1. Prevents infection in up to 89%

VIII. Drug Interactions: Live Attenuated Vaccines

  1. Immunoglobulin decreases immunogenicity
  2. Delay MMR for 3 months after Immunoglobulin
  3. Delay Varicella Vaccine for 5 months after Ig

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