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Children
In pediatric patients, the inactivated hepatitis A vaccine should be administered in doses of 25 units per mL (Vaqta) or 720 ELISA units per mL (Havrix).
In this case, the routine hepatitis A immunization schedule contemplates a 2-dose series in patients 12 months of age or older. It can also be administered in younger patients at a high risk of infection. This 2-dose series should include a starting dose of intramuscular 0.5 mL injection. After this primary dose, the booster dose should be given after 6 months. The booster dose can be delayed up to 12 months if the children are receiving Havrix vaccines or up to 18 months in the case of Vaqta vaccines.
Children who have not received their 2-dose series after 2 years old may still catch up with the schedule if desired, especially if they are going to be exposed to the virus in the future. Pre-exposure protection for traveler children should be given with immune globulins only in infants younger than 6 months. 6 to 11-month patients receive one injection of 0.5 mL, which does not count as a starting dose in their 2-dose routine series. 12-month to 18-year-old patients should complete their 2-dose series. In the case of immunocompromised patients, it is also essential to consider immunoglobulins.
For post-exposure immunization in children with no previous vaccination, they should be given a starting dose of 0.5 mL intramuscular and their booster dose. If they had been previously vaccinated, they could be given a post-exposure vaccine, but only one dose.
