What is the dosing schedule for Hepatitis A (Hep A) and Hepatitis B (Hep B) vaccination using Twinrix (Hepatitis A and Hepatitis B vaccine)

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Last updated: March 30, 2025View editorial policy

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From the Guidelines

The recommended dosing schedule for Twinrix, a hepatitis A and hepatitis B combination vaccine, is 3 doses at 0,1, and 6 months (standard) or 4 doses at 0 day, 7 days, 21–30 days, and 12 months (accelerated) for individuals aged 18 years and older. According to the most recent guidelines from the Advisory Committee on Immunization Practices (ACIP) in 2022 1, Twinrix is administered in a 1 mL dose, preferably as an intramuscular injection in the deltoid muscle. The standard schedule consists of three injections given over a 6-month period, while the accelerated schedule provides quicker protection with four doses given over a 12-month period. It is essential to complete the full series to develop long-term immunity against both hepatitis A and hepatitis B viruses. Key points to consider when administering Twinrix include:

  • The vaccine is approved for individuals 18 years and older
  • Each dose is 1 mL, administered intramuscularly in the deltoid muscle
  • The standard schedule is 3 doses at 0,1, and 6 months
  • The accelerated schedule is 4 doses at 0 day, 7 days, 21–30 days, and 12 months
  • Completing the full series is crucial for developing full immunity, as stated in the guidelines 1.

From the Research

Hepatitis Dosing Schedule for Twinrix

  • The standard dosing schedule for Twinrix, a combined hepatitis A and B vaccine, is not explicitly stated in the provided studies.
  • However, the studies suggest that the vaccine is typically administered in a series of doses, with the exact schedule not specified 2, 3.
  • One study mentions that the vaccination was repeated at 1 and 3 months after the initial dose 4.
  • Another study notes that the vaccine offers satisfactory long-term immunogenicity rates, expected duration of protection, and safety profile similar to the monovalent hepatitis A or B vaccines 2.
  • The immune response to hepatitis B surface antigen was found to be similar between the combined hepatitis A and B vaccine and the monovalent hepatitis B vaccine 3.
  • The studies do not provide a clear answer to the question of the specific dosing schedule for Twinrix, but they do suggest that the vaccine is effective in preventing hepatitis A and B infections 2, 5, 4, 6.

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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