If a person developed a severe local reaction after the first dose of hepatitis A vaccine, should we draw a titer before deciding whether to give the second dose?
No. Whether a second dose is contraindicated depends on the nature of the reaction; the response to the first dose is not a factor. A subsequent dose of vaccine is contraindicated if the reaction was a life-threatening, anaphylactic-type reaction. Local reactions, even exaggerated ones, do not contraindicate subsequent doses.
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