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Hepatitis A/B
A combination vaccine containing the same antigenic components as Engerix-B and pediatric Havrix (Twinrix - GlaxoSmithKline) is available for patients >18 years old. It is given in 3doses at 0, 1 and 6 months; at least 2 doses should be given before travel. Accelerated schedules of 0, 1 and 3 weeks with a fourth dose 12 months after the first, or 0, 1 and two weeks with a fourth dose at least 6 months after the first, can be given if necessary but are not FDA-approved. The combined vaccine can be used to complete an immunization series started with monovalent hepatitis A and B vaccines. Twinrix Junior is available in Canada and Europe for children 1-15 years old.
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