Summary
Hepatitis A vaccine is an inactivated vaccine and is available in the United Kingdom as a monovalent vaccine, or in combination with hepatitis B or typhoid vaccines.
Hepatitis A is generally a short-lived, self-limiting infection and serious complications are uncommon, although 10-15% of symptomatic individuals can have prolonged or relapsing disease lasting up to six months. Hepatitis A vaccination is indicated for individuals at increased risk of contracting the infection, or of fulminant hepatitis should infection occur. Hepatitis A infection during pregnancy is not believed to pose a risk to embryofetal development, although there is some evidence that acute infection during the second and third trimesters of pregnancy is associated with gestational complications and preterm labour.
An analysis of data from two clinical trials found that women exposed to hepatitis A vaccine within the 90 days preceding conception were not at increased risk of spontaneous abortion compared to women exposed to HPV vaccine. Further large, well-controlled studies of women exposed to hepatitis A vaccine in early pregnancy are, however, required before an increase in risk can be ruled out. The published data on other pregnancy outcomes following gestational exposure to hepatitis A vaccines are too limited/absent to facilitate an evidence-based assessment of any increased risk. However, there is a large body of evidence to suggest that inactivated vaccines as a group are not associated with an increased incidence of adverse fetal effects when used in pregnancy.
The Department of Health in the UK recommends that hepatitis A vaccine can be given to pregnant women if clinically indicated.
Inadvertent exposure to hepatitis A vaccine at any stage in pregnancy would not usually be regarded as medical grounds for termination of pregnancy or any additional fetal monitoring. However, other risk factors may be present in individual cases which may independently increase the risk of adverse pregnancy outcome. Clinicians are reminded of the importance of consideration of such factors when performing case-specific risk assessments.
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