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Hepatitis vaccine: Twinrix™   Leave a comment

Twinrix™ (GSK)
(from package insert, April 2004)

Vaccine type: combined inactivated Hepatitis A and surface antigen Hepatitis B

Composition (per 1.0ml dose):
720 ELISA units Hep A virus and 20mcg recombinant HBsAg


  • 16yo and above (3 doses): 1.0ml at 0, 1 month, 6 months (after 1st dose)
  • alternatively, if travel is anticipated urgently: 0, 7 days, 21 days; booster at 12 months
  • 1-15yo (2 doses): 1.0ml at 0 then 6-12 months
  • booster: Twinrix™ can be used if booster of both Hep A & B required. Alternatively, either monovalent vaccine may be used separately

  • intramuscular injection into deltoid or anterolateral thigh (infants); avoid gluteal

  • subcutaneous route may be used in bleeding disorders but suboptimal immune response may result

Contraindicated in:

  • anaphylaxis to neomycin
  • postpone in subjects with acute severe febrile illness

Use in pregnancy/lactation:

  • adequate data not available, but not expected to harm the foetus
  • used during pregnancy only when there is a clear risk of Hep A and B
  • use with caution in breastfeeding women

Some side effects:

  • common: fatigue, headache, malaise, nausea
  • uncommon: fever, vomiting
  • SE involving other organ systems are very rare