Disease Description: Hepatitis A and Hepatitis B are viral infections of the liver caused by Hepatitis A and Hepatitis B viruses respectively. For more details of illness caused by these viruses see description of the individual Hepatitis A and Hepatitis B vaccines.
Risk to Travelers: See information for the individual Hepatitis A and Hepatitis B vaccines for description of risks for travelers and maps showing worldwide disease prevalence.
Prevention - Vaccine: Twinrix is a combined hepatitis A and hepatitis B vaccine licensed for persons ≥18 years of age, containing 720 EL.U. of hepatitis A antigen (50% of the HAVRIX adult dose) and 20 μg of recombinant hepatitis B surface antigen protein (the same as the ENGERIX-B adult dose).
Primary immunization consists of three doses, given on a 0-, 1-, and 6-month schedule, the same schedule as that commonly used for monovalent hepatitis B vaccine.An accelerated schedule of Twinrix (i.e., doses at days 0, 7, and 21) for travelers has been approved by the FDA.
Vaccine Adverse Effects: Among adults, the most frequently reported side effects occurring 3 to 5 days after a vaccine dose are tenderness or pain at the injection site or headache.
Vaccine Contraindications: Twinrix should not be administered to travelers with a history of hypersensitivity reactions to the preservative 2-phenoxyethanol or with a history of hypersensitivity to yeast.
Vaccine Booster Recommendations: Persons who received Twinrix via the accelerated schedule should receive a booster dose at 1 year.
Information adapted from CDC Health Information for International Travel (the Yellow Book), http://www.cdc.gov/travel/yellowbook/2010/table-of-contents.htm