Introducing our new monthly feature, Ask the Doctor. Our healthcare partners will be answering your questions. To submit a question, please email

Carrie Vey, MD, FAAFP

Program Director, Halifax Health Family Medicine Residency Program & Sports Medicine

What is the purpose, benefits and risk of the Hepatitis A Vaccine? Why has this become highly suggested?

Hepatitis A is a serious liver disease, caused by the Hepatitis A Virus (HAV). HAV is spread person to person, through contact with stool of those who are infected, including if the infected person does not wash his or her hands properly. Hepatitis A can also be transmitted through contaminated food or water. Symptoms of hepatitis A include nausea, vomiting, fever, severe abdominal pain, diarrhea, and jaundice (yellowing of the skin). Hepatitis A can cause liver failure and even death, but this is more common in adults over 50 years of age.

Although the vaccine has been available for over twenty years, a recent outbreak of Hepatitis A in Florida has increased the attention to the disease and interest in the immunization. On August 1, 2019, the Florida Surgeon General issued a Public Health Emergency in response to the outbreak. There have been 2,540 cases of hepatitis A in Florida since January 1 of this year. There are over 200 reported cases in Volusia County, which is the third highest number of cases in the state of Florida. Flagler County Health Department has reported eight cases so far this year.

Since the Hepatitis A Vaccine became available in 1995, the rates of Hepatitis A infection have decreased by 95%. The vaccine is an inactivated, or killed, vaccine; there are no live or active components of the vaccine. The Centers for Disease Control recommends that children receive two doses of the vaccine, starting as early as 12 months of age. Adults can get the vaccine as well, if they have not previously been vaccinated, if they are traveling to a country where hepatitis A is common, or if they have chronic liver disease. The hepatitis A vaccine is considered very safe. Side effects to receiving the vaccine may include soreness at the injection site, low-grade fever, headache, and feeling tired, which usually resolve within one to two days.

What are the purpose, benefits, and risk for the HPV vaccine? Why is it controversial?

Human Papilloma Virus (HPV) is a very common virus that is known to cause warts on the skin and genitals. Most HPV infections will resolve on their own and not cause any serious problems. However, there are also high risk strains of the virus, which unfortunately can lead to various types of cancers – of the cervix, vagina, anus, throat, and penis. Cervical cancer is the fourth most common cancer among women, with over 12,000 cancer cases and 4,000 deaths each year in the United States. Virtually all cases of cervical cancer are linked to HPV infection, which can be detected early on with routine pap smears.

HPV virus is commonly spread through sexual contact, frequently seen in young sexually active men and women, even after the first time they have sex. It is estimated that at least 80 percent of sexually active men and women have been exposed to HPV once in
their lifetime.

The HPV vaccine is recommended by the Centers for Disease Control for both males and females and is recommended to be given starting at 11 years old. It can be given as early as nine years and can be given through adolescence. It is given as two or three shots, depending on the age of the first vaccine. Since HPV is spread through sexual contact, it is ideally administered prior to first sexual contact.

The HPV vaccine reduces risk of serious disease or cancer by up to 97-100 percent if given before first sexual contact. The vaccine is safe, but there are known side effects such as soreness and swelling at the injection site, fever, headache, and feeling faint after the injection. Some parents consider the HPV vaccine controversial because it is given to prevent a sexually transmitted disease. Because the vaccine is typically given at 11 years old, some parents may be uncomfortable having a discussion about sex with their children.

Dr. Meredith Brazell, DO

Dr. Brazell is a Pediatrician at Flagler Health+ Primary Care and Pediatrics at Palencia

What vaccines are recommended at each stage of a child’s growth – early childhood, upon entering school, transitioning to middle school and entering college?

Most vaccines for children are given in infancy up to entering school. These include Hepatitis B starting within the first 24 hours after birth. Subsequently, at ages two, four, and six months old, a child normally receives the remaining doses of Hepatitis B along with Diptheria, Tetanus, Pertussis (whooping cough), Polio, Pneumonia vaccine, Haemophilus influenzae, and Rotavirus (responsible for diarrhea – an oral medication). From a year old to four years old, they will be vaccinated against Measles, Mumps, Rubella, Varicella (chicken pox), and Hepatitis A along with finishing up the series of vaccines given as an infant. The next big round of vaccines occurs when the child is around middle school age of 11 years old when they get a booster of Tetanus, Diptheria, and Pertusis along with the Meningitis vaccine covering strains ACWY and their HPV (Gardasil) Vaccine. At 16, before entering college, children are then due for a second Meningitis vaccine covering ACWY along with another that covers strain B (MenB).

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