Who bears the costs for the hepatitis A and B vaccination?

You can protect yourself against the viruses hepatitis A and B by vaccination. Here, you will find all the information about risk groups, the vaccination process, possible side effects and the costs incurred, which in many cases are covered by health insurance companies.

What is hepatitis?

Hepatitis A and B are diseases of the liver, some of which can cause long-term damage to the body. Hepatitis B is the “more dangerous” of the two variants. The viral infection is one of the most widespread in the world and can destroy the liver if the disease progresses chronically.

The pathogen can enter the organism via blood or other body fluids. The virus can no longer be removed entirely from the body, so vaccination is the most important preventive measure against hepatitis B.

Hepatitis A is usually less damaging than hepatitis B, so the liver usually does not suffer permanent damage from the disease. However, hepatitis A only breaks out within 15 to 55 days. So, an unconscious infection of other people is very likely. Hepatitis A is transmitted by contact and smear infection.

 

Vaccination against hepatitis

The hepatitis vaccinations are usually given as basic immunizations and can be renewed every ten years if necessary. It is even assumed that the protection lasts for at least ten to twelve years and that a booster after the primary immunization is unnecessary without an increased risk of exposure.

A combination vaccination against hepatitis A and B is possible in Germany. But it is also possible to vaccinate against both diseases separately.

A so-called dead vaccine is injected. It is called that because the virus is only partially present and can no longer be transmitted. However, the antibodies are still formed in the body. A doctor usually gives the vaccinations.

When is a hepatitis B vaccination necessary?

Risk groups, in particular, should be vaccinated. Whether vaccination against hepatitis B is recommended for you depends on whether one or more of the following applies to you:

• You have come into contact with blood or other bodily fluids at work, for example, in the case of medical staff, nursing staff, social workers, police officers or prison staff.
• You have professional or private contact with people suffering from hepatitis, also in your wider circle of acquaintances (e.g. kindergarten, sports club) or live or work in shared accommodation (e.g. nursing home, psychiatric ward, prison).
• You have an immune deficiency.
• You are HIV positive.
• You have an increased risk of infection due to sexual behaviour, for example, frequently changing sex partners.
• You are a drug user.
• As a child, you did not receive any primary immunization against hepatitis B.
• You will be abroad shortly. Risk areas include Australia, Central Africa and Southeast Asia.

Newborns in Germany have been immunized against hepatitis B since 1995. The vaccination lasts into adulthood and can be boosted every ten years if necessary.

 

Hepatitis A: The risk group

Vaccination against hepatitis A is recommended if you belong to one of the following risk groups:

• You already have chronic liver disease.
• You are regularly injected with blood or blood components.
• Because of your sexual behaviour, you have an increased risk of infection.
• You live in a facility for people with behavioural disorders or cerebral damage, such as a psychiatric facility.
• You work in the health service (including laboratory work) or a community facility (e.g. in daycare centres, workshops for people with disabilities, etc.).
• You have professional contact with wastewater, for example, in a sewage treatment plant or when working in the sewage system.
• You are planning a trip to an endangered region: the Near and Middle East, Turkey and Asia, Africa and the Mediterranean are considered risk areas.

How does the vaccination work?

In the case of a combination vaccination against hepatitis A and B, three vaccinations are usually necessary to receive complete vaccination protection. The first vaccination is carried out approximately four weeks before the second vaccination and six months before the third vaccination. After the second vaccination, the antibodies form. At least ten to twelve years of protection is achieved the third time.

The blood is tested about four to eight weeks after the last vaccination. If antibodies are found, the hepatitis vaccination has gone according to plan. If there are no or too few antibodies in the body, the fourth vaccination must be given.

Of course, both vaccinations can also be carried out separately. For the hepatitis A vaccination, you only need two vaccinations to be basic immunized.

Non- and low-responders to hepatitis vaccination

The success or the formation of antibodies in a hepatitis vaccination can depend on age, gender, existing diseases or other factors such as genetics.

About five per cent of all vaccinated people form no or too few antibodies after the vaccination. These people are then referred to as so-called non- or low-responders. In the case of the latter, it is recommended to vaccinate again up to three times at intervals of four to eight weeks; in the case of non-responders, various strategies have been discussed.

 

Vaccination in infants

The hepatitis B vaccine is usually injected during infancy or infancy. Vaccination requires three sessions. Babies aged two, four, and eleven to 14 months are given primary immunization against hepatitis B according to the vaccination guidelines of the Federal Joint Committee on Vaccination. Another vaccination may be necessary at three months, depending on the vaccination schedule.

Are there any side effects from the vaccination?

In most cases, the injection is given into the muscle of the upper arm. The vaccine is considered to be well tolerated. However, side effects such as gastrointestinal problems, tiredness, redness and swelling at the injection site are possible up to two days after the vaccination.

How much does the hepatitis vaccination cost?

 Approximately 50 to 65 euros can be expected for each hepatitis A vaccination. A primary immunization with two injections costs about 100 to 130 euros.

A hepatitis B vaccination is slightly more expensive at 50 to 70 euros per injection. A primary immunization with three vaccinations (for an adult) costs around 150 to 210 euros. However, since most adults were already vaccinated against hepatitis B as children, only one booster vaccination is usually charged here.

With a combined vaccination against both forms of hepatitis (A and B), about 180 to 240 euros must be paid for the primary immunization.

Depending on the doctor’s practice, the prices also include fees for the consultation and the doctor’s or nurse’s fee. Here you should expect up to 40 euros.

 

Who pays for the vaccination?

One can say that for children under 18, the hepatitis B vaccination is paid for by all statutory health insurance companies and is strongly recommended. Depending on the situation (e.g., staying abroad, contact with risk groups, etc.), the hepatitis A vaccination for children is covered by health insurance.

The vaccinations against the hepatitis virus are used as indication vaccinations for adults. This means The hepatitis A and B vaccinations are recommended for certain risk groups and under certain conditions and are paid for by health insurance. You must pay for the vaccination if you do not belong to such a risk group.

If the hepatitis vaccination is to be carried out as a travel vaccination, the health insurance company decides on a case-by-case basis whether there is a risk and the costs are covered.

Payable by the employer

However, there is also the possibility that the employer will pay for the vaccination if there is a higher probability of coming into contact with the pathogen for work-related reasons. This is the case in all professions that come into contact with bodily fluids, such as nurses, laboratory workers, sewage treatment plant workers, and pathologists. Here, the employer can pay for the hepatitis A and B vaccination.

If you are still determining which risk group you belong to due to your professional and private situation, ask your health insurance company and then your employer whether the assumption of costs is an option for you.