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Combination Vaccine for Hepatitis A and B


Generic Name Brand Name
hepatitis A inactivated and hepatitis B recombinant vaccine Twinrix

How It Works

Twinrix is a vaccine that provides active immunity against both the hepatitis A and hepatitis B viruses. It is usually given in a series of 3 injections on the same schedule as the hepatitis B vaccine: an initial dose followed by doses at 1 month and 6 months.

Why It Is Used

The Public Health Agency of Canada has approved its use only for people who are at risk for infection with HAV and HBV. These include people who:

  • Will travel to areas with moderate to high rates of HAV and HBV. These include Africa, the Caribbean, Central America, South America, Mexico, South and Southeast Asia, the Middle East, Eastern Europe, Southern Europe, and the former Soviet Union.footnote 1
  • Have long-term (chronic) liver disease.
  • Use illegal injectable drugs.
  • Have anal contact with a sex partner.
  • Work in occupations that expose them to viruses, such as some lab workers, people who provide emergency medical assistance, and daycare providers.
  • Have clotting factor disorders and receive blood products.

How Well It Works

Hepatitis B vaccine provides immunity for 95% to 97% of people.

Immunity to the hepatitis B virus is thought to be lifelong. The hepatitis A vaccine is effective for at least 25 years in adults and at least 14 to 20 years in children.footnote 3

Side Effects

Ask your vaccine provider about the side effects of this vaccine.

Call 911 or other emergency services right away if you have:

  • Trouble breathing.
  • Swelling of your face, lips, tongue, or throat.

Call your doctor if you have:

  • Hives.

Common side effects of the Twinrix vaccine include:

  • Soreness at the injection site.
  • Headache.
  • Fatigue.

What To Think About

Twinrix should not be given to people who are allergic to the contents of the vaccine.

To get the best protection before travel, you need 2 doses of Twinrix before you leave. If you are travelling in less than 21 days, then you should get separate hepatitis A and B vaccines to give you the best protection for your trip.

Complete the new medication information form (PDF)( What is a PDF document? ) to help you understand this medication.



  1. Sharapov UM, Teshale EH (2014). Infectious diseases related to travel: Hepatitis A. Centers for Disease Control and Prevention. Accessed December 24, 2014.
  2. Twinrix: A combination hepatitis A and B vaccine (2001). Medical Letter on Drugs and Therapeutics, 43(1110): 67–68.
  3. Centers for Disease Control and Prevention (2013). Hepatitis A FAQs for health professionals. Centers for Disease Control and Prevention. Accessed December 24, 2014.


Current as ofJuly 30, 2018

Author: Healthwise Staff
Medical Review: E. Gregory Thompson, MD - Internal Medicine
Brian D. O'Brien, MD - Internal Medicine
Adam Husney, MD - Family Medicine
W. David Colby IV, MSc, MD, FRCPC - Infectious Disease
W. Thomas London, MD - Hepatology