Medical Editor: John P. Cunha, DO, FACOEP
What Is Havrix?
Havrix (hepatitis a vaccine, inactivated) is a vaccine used to help prevent the Hepatitis A disease in adults. Havrix is recommended for adults who have risk factors for getting Hepatitis A, including: being a homosexual male; having chronic liver disease; using intravenous (IV) drugs; receiving treatment for hemophilia or other bleeding disorders; working in a research laboratory or around animals (especially monkeys) where you may be exposed to the hepatitis A virus; or being in an area where there has been an outbreak of hepatitis A.
What Are Side Effects of Havrix?
Common side effects of Havrix include:
- injection site reactions (pain, redness, swelling, or a hard lump),
- low fever,
- stomach pain,
- loss of appetite,
- joint pain, or
- sore throat.
Tell your doctor if you have infrequent and temporary symptoms such as:
- vision changes,
- numbness or tingling, or
- seizure-like after receiving a vaccine injection such as Havrix.
Dosage for Havrix
Primary immunization for adults consists of a single 1-mL dose of Havrix and a 1-mL booster dose administered anytime between 6 and 12 months later.
What Drugs, Substances, or Supplements Interact with Havrix?
Havrix may interact with drugs or treatments that can weaken the immune system, such as steroids, medications to treat psoriasis, rheumatoid arthritis, or other autoimmune disorders, or medicines to treat or prevent organ transplant rejection. Tell your doctor all medications you use, and all other vaccines you recently received.
Havrix During Pregnancy and Breastfeeding
During pregnancy, Havrix should be used only when prescribed. It is unknown if this drug passes into breast milk. Consult your doctor before breastfeeding.
Our Havrix (hepatitis a vaccine) Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
You should not receive a booster vaccine if you had a life threatening allergic reaction after the first shot.
Keep track of any and all side effects you have after receiving this vaccine. When you receive a booster dose, you will need to tell the doctor if the previous shot caused any side effects.
Call your doctor at once if you have:
- extreme drowsiness, fainting; or
- high fever (within a few hours or a few days after the vaccine).
Common side effects may include:
- headache; or
- swelling, tenderness, redness, or warmth where the shot was given.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report vaccine side effects to the US Department of Health and Human Services at 1-800-822-7967.
Clinical Trials Experience
Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a vaccine cannot be directly compared to rates in the clinical trials of another vaccine, and may not reflect the rates observed in practice.
The safety of HAVRIX has been evaluated in 61 clinical trials involving more than 34,000 individuals receiving doses of 360 EL.U., 720 EL.U., or 1440 EL.U.
Of solicited adverse events in clinical trials of adults, who received HAVRIX 1440 EL.U., and children (2 years of age and older), who received either HAVRIX 360 EL.U. or 720 EL.U., the most frequently reported was injection-site soreness (56% of adults and 21% of children); less than 0.5% of soreness was reported as severe. Headache was reported by 14% of adults and less than 9% of children. Other solicited and unsolicited events occurring during clinical trials are listed below.
Incidence 1% to 10% of Injections
Metabolism and Nutrition Disorders: Anorexia.
Gastrointestinal Disorders: Nausea.
General Disorders and Administration Site Conditions: Fatigue, fever > 99.5°F (37.5°C), induration, redness, and swelling of the injection site; malaise.
Incidence < 1% of Injections
Infections and Infestations: Pharyngitis, upper respiratory tract infections.
Blood and Lymphatic System Disorders: Lymphadenopathy.
Psychiatric Disorders: Insomnia.
Nervous System Disorders: Dysgeusia, hypertonia.
Eye Disorders: Photophobia.
Ear and Labyrinth Disorders: Vertigo.
Gastrointestinal Disorders: Abdominal pain, diarrhea, vomiting.
Skin and Subcutaneous Tissue Disorders: Pruritus, rash, urticaria.
Musculoskeletal and Connective Tissue Disorders: Arthralgia, myalgia.
General Disorders and Administration Site Conditions: Injection site hematoma.
Investigations: Creatine phosphokinase increased.
Studies of HAVRIX 720 EL.U./0.5 mL in Children 11 to 25 Months of Age
In 4 studies, 3,152 children 11 to 25 months of age received at least one dose of HAVRIX 720 EL.U. administered alone or concomitantly with other routine childhood vaccinations [see Clinical Studies]. The studies included HAV 210 (N = 1,084), HAV 232 (N = 394), HAV 220 (N = 433), and HAV 231 (N = 1,241).
In the largest of these studies (HAV 231) conducted in the US, 1,241 children 15 months of age were randomized to receive: Group 1) HAVRIX alone; Group 2) HAVRIX concomitantly with measles, mumps, and rubella (MMR) vaccine (manufactured by Merck and Co.) and varicella vaccine (manufactured by Merck and Co.); or Group 3) MMR and varicella vaccines. Subjects in Group 3 who received MMR and varicella vaccines received the first dose of HAVRIX 42 days later. A second dose of HAVRIX was administered to all subjects 6 to 9 months after the first dose of HAVRIX. Solicited local adverse reactions and general events were recorded by parents/guardians on diary cards for 4 days (days 0 to 3) after vaccination. Unsolicited adverse events were recorded on the diary card for 31 days after vaccination. Telephone follow-up was conducted 6 months after the last vaccination to inquire about serious adverse events, new onset chronic illnesses and medically significant events. A total of 1,035 children completed the 6-month follow-up. Among subjects in all groups combined, 53% were male; 69% of subjects were white, 16% were Hispanic, 9% were black and 6% were other racial/ethnic groups.
Percentages of subjects with solicited local adverse reactions and general adverse events following HAVRIX administered alone (Group 1) or concomitantly with MMR and varicella vaccines (Group 2) are presented in Table 1. The solicited adverse events from the 3 additional coadministration studies conducted with HAVRIX were comparable to those from Study HAV 231.
Table 1: Solicited Local Adverse Reactions and General
Adverse Events Occurring Within 4 Days of Vaccinationa in Children 15 to 24
Months of Age With HAVRIX Administered Alone or Concomitantly With MMR and
Varicella Vaccines (TVC)
|Group 1 HAVRIX Dose 1 %||Group 2 HAVRIX+ MMR+Vb Dose 1 %||Group 1 HAVRIX Dose 2 %||Group 2 HAVRIX Dose 2 %|
|Local (at injection site for HAVRIX)|
|Irritability, grade 3||0.3||1.9||1.5||0.3|
|Drowsiness, grade 3||1.0||2.2||1.1||0.0|
|Loss of appetite, any||18.3||26.1||19.9||20.5|
|Loss of appetite, grade 3||1.0||1.4||0.4||0.3|
|Fever ≥ 100.6°F (38.1°C)||3.0||4.8||3.3||2.7|
|Fever ≥ 101.5°F (38.6°C)||2.0||2.6||1.8||1.6|
|Fever ≥ 102.4°F (39.1°C)||0.7||0.7||0.4||1.1|
|Total vaccinated cohort (TVC) = all subjects who received
at least one dose of vaccine.
N = number of subjects who received at least one dose of vaccine and for whom diary card information was available.
Grade 3: drowsiness defined as prevented normal daily activities; irritability/fussiness defined as crying that could not be comforted/prevented normal daily activities; loss of appetite defined as no eating at all.
a Within 4 days of vaccination defined as day of vaccination and the next 3 days.
b MMR = measles, mumps, and rubella vaccine; V = varicella vaccine.
Serious Adverse Events in Children 11 to 25 Months of Age
Among these 4 studies, 0.9% (29/3,152) of subjects reported a serious adverse event within the 31-day period following vaccination with HAVRIX. Among subjects administered HAVRIX alone 1.0% (13/1,332) reported a serious adverse event. Among subjects who received HAVRIX concomitantly with other childhood vaccines, 0.9% (8/909) reported a serious adverse event. In these 4 studies, there were 4 reports of seizure within 31 days post-vaccination: these occurred 2, 9, and 27 days following the first dose of HAVRIX administered alone and 12 days following the second dose of HAVRIX. In one subject who received INFANRIX and Hib conjugate vaccine followed by HAVRIX 6 weeks later, bronchial hyperreactivity and respiratory distress were reported on the day of administration of HAVRIX alone.
In addition to reports in clinical trials, worldwide voluntary reports of adverse events received for HAVRIX since market introduction of this vaccine are listed below. This list includes serious adverse events or events which have a suspected causal connection to components of HAVRIX or other vaccines or drugs. Because these events are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to the vaccine.
Infections and Infestations: Rhinitis.
Blood and Lymphatic System Disorders: Thrombocytopenia.
Immune System Disorders: Anaphylactic reaction, anaphylactoid reaction, serum sickness-like syndrome.
Nervous System Disorders: Convulsion, dizziness, encephalopathy, Guillain-Barre syndrome, hypoesthesia, multiple sclerosis, myelitis, neuropathy, paresthesia, somnolence, syncope.
Vascular Disorders: Vasculitis.
Respiratory, Thoracic, and Mediastinal Disorders: Dyspnea.
Hepatobiliary Disorders: Hepatitis, jaundice.
Skin and Subcutaneous Tissue Disorders: Angioedema, erythema multiforme, hyperhidrosis.
Congenital, Familial, and Genetic Disorders: Congenital anomaly.
Musculoskeletal and Connective Tissue Disorders: Musculoskeletal stiffness.
General Disorders and Administration Site Conditions: Chills, influenza-like symptoms, injection site reaction, local swelling.
Read the entire FDA prescribing information for Havrix (Hepatitis A Vaccine, Inactivated)
© Havrix Patient Information is supplied by Cerner Multum, Inc. and Havrix Consumer information is supplied by First Databank, Inc., used under license and subject to their respective copyrights.
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