Hepatitis A Vaccine for Immigration: 2-Dose Series, Titer Testing, and Combination Vaccine
Quick Answer
The hepatitis A vaccine is given as a 2-dose series for immigration applicants who are age-eligible. Titer testing (anti-HAV IgG) is an accepted alternative — a positive result confirms immunity from prior vaccination or infection. A combination hepatitis A/B vaccine (Twinrix) can satisfy both requirements simultaneously for eligible adults.
Hepatitis A Vaccine Requirement for Immigration
Hepatitis A vaccine is an ACIP-recommended vaccine required for immigration applicants who are age-eligible. ACIP recommends hepatitis A vaccination for all children at age 1 year, for unvaccinated children and adolescents through age 18, and for adults at increased risk of hepatitis A or severe outcomes from hepatitis A infection. For immigration purposes, the civil surgeon will assess whether hepatitis A vaccine is required based on your age and vaccination history.
The 2-Dose Hepatitis A Series
The hepatitis A vaccine is given as a 2-dose series. The second dose is given 6–18 months after the first dose. Both doses are needed for long-term protection. If you have received only one dose, you will need to complete the series. The civil surgeon will schedule a follow-up appointment for the second dose. A combination hepatitis A and hepatitis B vaccine (Twinrix) is also available for adults and can be used to satisfy both requirements simultaneously.
Titer Testing as an Alternative
Hepatitis A titer testing (anti-HAV IgG) is available and accepted for immigration purposes. A positive titer demonstrates immunity to hepatitis A, either from prior vaccination or prior infection. If your titer is positive, you do not need to receive the hepatitis A vaccine. Titer testing is particularly useful for individuals who may have had hepatitis A infection in the past or who were vaccinated but lack documentation.
Prior Hepatitis A Infection
If you had hepatitis A disease in the past, you likely have lifelong immunity. A positive hepatitis A titer (anti-HAV IgG) will confirm this immunity. Bring any medical records documenting prior hepatitis A infection to your appointment. If you have documentation of prior infection, the civil surgeon may accept this as evidence of immunity without requiring titer testing.
Combination Hepatitis A/B Vaccine
Twinrix is a combination vaccine that protects against both hepatitis A and hepatitis B. It is approved for adults 18 years and older and is given as a 3-dose series (at 0, 1, and 6 months) or an accelerated 4-dose series (at 0, 7, 21–30 days, and 12 months). If you need both hepatitis A and hepatitis B vaccines, Twinrix can satisfy both requirements with a single series.
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