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About TWINRIX

TWINRIX is the only dual hepatitis A and B vaccine. It's given as a series of doses (injections) by a healthcare professional. TWINRIX is used in adults, adolescents, children, and infants to prevent hepatitis A and hepatitis B diseases.

Vaccination is the best way to prevent hepatitis A and B infection.

According to Canadian medical guidelines, vaccination is recommended for all those who wish to decrease their risk of contracting hepatitis A and B.

Specifically, vaccination against hepatitis A is recommended for anyone who:

Travels to countries or areas with a moderate to high risk for hepatitis A

Serves in the Canadian armed forces, emergency relief organization, or other group likely to be posted at short notice to areas with a high risk for hepatitis A

Works closely with non-human primates: zookeepers, veterinarians, and researchers

Has been diagnosed with chronic liver disease

Receives clotting factor concentrates

Lives in a community with a high risk for hepatitis A

Is male and has sexual contact with men

Lives with a child adopted from a country or area with a moderate to high risk for hepatitis A

Uses drugs illicitly

Wants to decrease his or her risk for hepatitis A

Works with or studies the hepatitis A virus such as a researcher or laboratory technician

Vaccination against hepatitis B is recommended for anyone who:

Travels to countries or areas with a moderate to high risk for hepatitis B

Works as a healthcare worker, including medical students. Health care workers can be exposed to hepatitis B through:

  • Exposure to blood or bodily fluids
  • Injury by medical instruments contaminated by blood

Works or resides at a correctional facility or at an institution for the developmentally-challenged

Lives with—or has had sexual contact with—a person with hepatitis B

Is male and has sexual contact with men

Lives in a community with a high risk for hepatitis A

Has unprotected sex with new partners or who has had 2 or more sexual partners in the past 6 months

Has a history of sexually-transmitted infections (STIs), attending an STI clinic, or engages in other risky sexual activity

Uses injection drugs

Has hemophilia or any other condition that requires repeated blood infusions

Is a hemodialysis patient

Lives with a congenital immunodeficiency

Is infected with the HIV virus

Is diagnosed with chronic liver disease

Wants to decrease his or her risk for hepatitis B

Is an adult or child immigrant coming to Canada from a high-risk country

Works or attends a childcare facility that cares for a hepatitis B-infected child

Vaccination is the best way to prevent hepatitis A and B infection.

The TWINRIX vaccine works by helping your body produce its own protection (antibodies) against hepatitis A and B.

Vaccination is the best way to prevent hepatitis A and B infection.

Before getting vaccinated, tell your healthcare provider if you:

Are pregnant or planning to be

Are breastfeeding

Have a poor immune system due to illness or drug treatment

Have a bleeding problem or bruise easily

Are taking any other medicine or have recently received another vaccine

Have any known allergies

The price of TWINRIX may vary. Depending on private insurance plans, the acquisition cost may be covered or subsidized.

Contact your insurance provider and ask about your coverage for hepatitis A and B vaccination.

Standard TWINRIX dosing is 3 vaccine doses over a span of 6 months.

You choose the date for the first dose. The second dose is 1 month after the first and the last dose is 6 months after the first.

A 4-dose rapid schedule is also available for adults 19 years and older.

Even if you're a last-minute traveller, talk to your healthcare provider or visit your local travel clinic.

TWINRIX can be administered at the vaccination schedules shown below. Your healthcare provider will advise you of the dosing that’s right for you.

Adult TWINRIX Vaccination Schedules

Age group Vaccine
Dose #1
Vaccine
Dose #2
Vaccine
Dose #3
Vaccine
Dose #4
Standard schedule*
TWINRIX 1.0 mL
Adults 19 years of age and older You choose
the date.
1 month
after the
first dose.
6 months
after the
first dose.
--
Rapid schedule*
TWINRIX 1.0 mL
Adults 19 years of age and older You choose
the date.
1 week
after the
first dose.
3 weeks
after the
first dose.
1 year
after the
first dose.
Standard
schedule*

TWINRIX 1.0 mL
Rapid
schedule*

TWINRIX 1.0 mL
Age
group
Adults 19
years of age
and older
Adults 19
years of age
and older
Vaccine
Dose #1
You choose
the date.
You choose
the date.
Vaccine
Dose #2
1 month
after the
first dose.
1 month
after the
first dose.
Vaccine
Dose #3
6 months
after the
first dose.
3 weeks
after the
first dose.
Vaccine
Dose #4
-- 1 year
after the
first dose.

* For long-term protection, all scheduled doses must be received.

Required only for rapid dosing.

You must get all your scheduled TWINRIX vaccine doses.

Otherwise, you may not be full protected against hepatitis A and B.

If you miss a dose, call your healthcare provider to reschedule another visit.

Get helpful reminders.

The TWINRIX Dose Reminders service is a simple, convenient way to get timely vaccine reminders.

Sign up now

Immunization may not be suitable for everyone and can be associated with adverse events. Be sure to consult your healthcare provider to see which options are right for you. 100% protection cannot be guaranteed and additional doses may be required.

For long-term protection against hepatitis A and B, you must complete all your scheduled TWINRIX doses.

The standard dosing schedule (3 doses) requires the third dose 6 months after the administration of the first dose.

The 4-dose rapid schedule (available for adults 19 years and older) requires the fourth dose 12 months after the administration of the first dose.

Complete your TWINRIX doses!

Make sure you finish the complete vaccination course. Otherwise, you may not be fully protected against hepatitis A and B.

If you miss a dose, call your healthcare provider to reschedule another visit.

Get helpful reminders.

The TWINRIX Dose Reminders service is a simple, convenient way to get timely vaccine reminders.

Sign up now

Immunization may not be suitable for everyone and can be associated with adverse events. Be sure to consult your healthcare provider to see which options are right for you. 100% protection cannot be guaranteed and additional doses may be required.

Yes.

The standard children’s TWINRIX schedule for adolescents, children, and infants ages 1-18 years uses the TWINRIX Junior vaccine and requires 3 doses over a span of 6 months.

You choose the date for the first dose. The second dose is 1 month after the first and the last dose is 6 months after the first.

TWINRIX can be administered at the vaccination schedules shown below. Your healthcare provider will advise you of the dosing that’s right for your child.

Children's TWINRIX Vaccination Schedules

Age group Vaccine
Dose #1
Vaccine
Dose #2
Vaccine
Dose #3
Standard schedule*
TWINRIX Junior 0.5 mL
1-18 years You choose
the date.
1 month
after the
first dose.
6 months
after the
first dose.
Alternate schedule*
TWINRIX 1.0 mL
1-15 years You choose
the date.
6-12 months
after the
first dose.
--
Standard
schedule*

TWINRIX Junior 0.5 mL
Alternate
schedule*

TWINRIX 1.0 mL
Age
group
1-18 years 1-15 years
Vaccine
Dose #1
You choose
the date.
You choose
the date.
Vaccine
Dose #2
1 month
after the
first dose.
6-12 months
after the
first dose.
Vaccine
Dose #3
6 months
after the
first dose.
--

* For long-term protection, all scheduled doses must be received.

Your child must complete all scheduled TWINRIX doses.

Otherwise, he or she may not be fully protected against hepatitis A and B.

If your child misses a dose, call your healthcare provider to reschedule another visit.

Get helpful reminders.

The TWINRIX Dose Reminders service is a simple, convenient way to get timely vaccine reminders.

Sign up now

If you've started your TWINRIX schedule, you will need to complete the vaccination series. Otherwise, you may not be fully protected against hepatitis A and B.

Standard TWINRIX dosing is 3 vaccine doses over a span of 6 months.

You choose the date for the first dose. The second dose is 1 month after the first and the last dose is 6 months after the first.

A 4-dose rapid schedule is also available for adults 19 years and older.

Even if you’re a last-minute traveller, talk to your healthcare provider.

Complete your TWINRIX doses!
You must get all your remaining TWINRIX doses.

Otherwise, you may not be fully protected against hepatitis A and B.

If you miss a dose, call your healthcare provider to reschedule another visit.

Get helpful reminders.

The TWINRIX Dose Reminders service is a simple, convenient way to get timely vaccine reminders.

Sign up now

If you have missed a scheduled vaccine dose, talk to your healthcare provider and book another appointment.

Make sure you finish the complete TWINRIX vaccination course.

Otherwise, you may not be fully protected against hepatitis A and B.

Need a little help remembering to complete your TWINRIX doses?

The TWINRIX Dose Reminders service is a simple, convenient way to get timely vaccine reminders.

Sign up now

Being prepared can help you make the most of your pre-travel medical appointment.

The following lists include questions you may want to ask, as well as important information to bring with you and share with your healthcare provider.

Questions to ask

Is my destination a risk for hepatitis A and B?

What are the possible consequences of hepatitis A and B?*

Is TWINRIX right for me?

Will I need any other vaccinations or medications for my trip?

How many TWINRIX doses will I need?

When should I have them?

Should my partner and/or children also be vaccinated?

Can I get TWINRIX if I'm on other medications?

Do I need to receive all TWINRIX doses before travelling?

Information to bring

Your destination's name (city/country, area, resort/hotel, staying with relatives, etc.)

Expected length of stay

Your vaccination history

List of any medications you are currently taking

List of any allergies you have

Follow this link to create a personalized checklist of questions and information to share with your healthcare provider.

Download pre-travel checklist

* TWINRIX is not indicated to treat the symptoms of, or reduce the serious consequences associated with hepatitis A and B.

Travelling to areas where hepatitis A or B is endemic (constantly present), such as the Caribbean, puts anyone at risk for infection.

Resort activities that may put travellers at risk for hepatitis A include:

Eating food or drinking beverages that have been contaminated by human waste.

Eating food handled by an infected worker who did not wash his/her hands properly after using the washroom

Eating raw or undercooked seafood and shellfish that lived in sewage-polluted water

Eating salads or produce rinsed in contaminated water

Drinking contaminated water or drinks with contaminated ice

Bathing, showering, or swimming in contaminated water

Resort activities that may put travellers at risk for hepatitis B include:

Getting a manicure, pedicure, tattoo, piercing, or acupuncture with improperly sterilized tools

Having sexual contact with an infected partner

Giving first aid to, or receiving it from, an infected person

Receiving medical or dental procedure with contaminated equipment

Sharing personal grooming items (such as nail clippers) with an infected person

Encourage friends and family who are travelling with you to ask their healthcare providers about TWINRIX.

Look for these icons to share links to this site.

Side effects that occurred in adults during clinical trials with the standard (3 dose) and the rapid (4 dose) TWINRIX vaccination schedule were:

Very common (more than 10% of doses): Pain or discomfort, redness at the injection site, headache and tiredness

Common (between 1% and 10% of doses): Swelling at the injection site, diarrhea, nausea, vomiting and generally feeling unwell

Uncommon (between 0.1% and 1% of doses): Fever (over 37.5°C), dizziness, upper respiratory tract infection, and aching muscles

Rare (between 0.01% and 0.1% of doses): Swollen glands in the neck, armpit or groin, loss of appetite, pins and needles, low blood pressure, rash and itching, muscle and joint pain and flu- like symptoms, such as high temperature, sore throat, runny nose, cough and chills

Very rare (less than 0.01% of doses): Hives

Side effects that occurred in children who received the standard (3 dose) TWINRIX Junior vaccination schedule were:

Very common (more than 10% of doses): Pain and redness at the injection site

Common (between 1% and 10% of doses): Swelling at the injection site, fever (more than 37.5ºC), irritability, drowsiness, headache, loss of appetite, diarrhea, nausea, vomiting and generally feeling unwell

Uncommon (between 0.% and 1% of doses): Rash

Rare (between 0.01% and 0.1% of doses): Swollen glands in the neck, armpit or groin, dizziness and hives

Very rare (less than 0.01% of doses): Pins and needles, loss of skin sensitivity to pain or touch, numbness of the arms and legs, low blood pressure, rash and itching, aching muscles and joint pain and flu-like symptoms, such as high temperature, sore throat, runny nose, cough and chills

Side effects that occurred in children during clinical trials who received the alternate (2 dose) TWINRIX vaccination schedule were:

Very common (more than 10% of doses): Pain and redness at the injection site, tiredness, headache, irritability and loss of appetite

Common (between 1% and 10% of doses): Swelling at the injection site, fever, drowsiness, stomach and digestive complaints

Do not be alarmed by this list of possible side effects. It is likely that you will have no side effects from vaccination.

This is not a complete list of side effects. For any unexpected effects while taking TWINRIX, contact your healthcare provider.

Anyone experiencing a fever or anything more serious than a minor cold should postpone vaccination.

Pregnant women should discuss the possible risks and benefits of vaccination with their healthcare provider.

TWINRIX should not be used if you have:

Experienced any health problems after the administration of a vaccine

Experienced any allergic reaction to TWINRIX or any ingredient contained in this vaccine*

  • Signs of an allergic reaction may include itchy skin rash, shortness of breath and swelling of the face or tongue

Experienced any allergic reaction to vaccines against hepatitis A and hepatitis B diseases

A severe infection with a high temperature (over 38°C).

  • A minor infection such as a cold should not be a problem, but talk to your healthcare provider first

* TWINRIX vaccine contains inactivated hepatitis A virus [adsorbed on aluminum-oxide hydrated] and hepatitis B virus surface antigen recombinant (S protein) [adsorbed on aluminum phosphate produced on genetically-engineered yeast cells (Saccharomyces cerevisiae)].

No. TWINRIX does not contain living viruses, so it is impossible to get hepatitis A or B from the vaccine.

Store TWINRIX in a refrigerator (2 - 8°C), keeping it in the original package to protect it from light.

Do not freeze TWINRIX as this will destroy the vaccine.

Keep the package out of the reach and sight of children.

About hepatitis A and B

Hepatitis A and B are two serious liver diseases caused by the hepatitis A and B viruses. Both viruses are endemic (constantly present) in much of the developing world. Many popular travel destinations such as the Caribbean are considered risk areas for unprotected travellers. In fact, you can contract hepatitis A or B even if you stay at a 5-star resort.

Why risk it?

Vaccination is the best way to prevent hepatitis A and B infection.

You can contract the hepatitis A virus by eating food or drinking beverages that have been contaminated by human waste.

Resort activities that may put you at risk for hepatitis A include:

Eating food handled by an infected worker who did not wash his/her hands properly after using the washroom

Eating raw or undercooked seafood and shellfish that lived in sewage-polluted water

Eating salads or produce rinsed in contaminated water

Drinking contaminated water or drinks with contaminated ice

Bathing, showering, or swimming in contaminated water

Hepatitis A can survive up to 10 months in water and on dried surfaces for 7 days.

Why risk it?

Vaccination is the best way to prevent hepatitis A and B infection.

You can contract hepatitis B by coming into contact with the bodily fluids (such as blood, semen, vaginal fluid or saliva) of an infected person.

Resort activities that may put you at risk for hepatitis B include:

Getting a manicure, pedicure, tattoo, piercing, or acupuncture with improperly sterilized tools

Having sexual contact with an infected partner

Giving first aid to, or receiving it from, an infected person

Receiving medical or dental procedure with contaminated equipment

Sharing personal grooming items (such as nail clippers) with an infected person

Hepatitis B can survive on surfaces for at least 7 days.

Why risk it?

Vaccination is the best way to prevent hepatitis A and B infection.

Certain people are at increased risk for hepatitis A and B.

You have an increased chance of contracting hepatitis A if you:

Travel to regions where hepatitis A is common (such as the Caribbean, South America)

Live with someone who is newly infected

Travel/return to your country of origin, a hepatitis A endemic country

Engage in sexual activity involving oral/anal contact

Share contaminated drug preparation/injection materials

You have an increased chance of contracting hepatitis B if you:

Travel to regions where hepatitis B is more common (such as certain parts of the Caribbean, Africa, and Asia)

Have unprotected sex with new partners

Get a tattoo or piercing with contaminated tools

Have a job that exposes you to blood or bodily fluids, such as healthcare and emergency service workers, police, firefighters, staff of institutions for the developmentally-challenged or correctional facilities, etc.

Share contaminated drug preparation/injection materials

Share a household with an infected person

Why risk it?

Vaccination is the best way to prevent hepatitis A and B infection.

Hepatitis A occurs worldwide.

Regions with a moderate to high risk for hepatitis A infection include—but not limited to—popular travel destinations such as the Caribbean, South Asia, Sub-Saharan Africa, Central Asia, Latin America, North Africa, Middle East, and Oceania.

Although hepatitis A is more common in these areas, cases occur in Canada as well.

Countries or areas with moderate to high risk are shaded red.

Why risk it?

Vaccination is the best way to prevent hepatitis A and B infection.

Hepatitis B occurs worldwide.

Regions with a moderate to high risk for hepatitis B infection include—but not limited to—popular travel destinations such as the Caribbean, Far East, the Middle East, Africa, South America, Eastern Europe, and Central Asia.

It's important to know that while hepatitis B is more common in these areas, cases occur in Canada as well.

Countries or areas with moderate to high risk are shaded red.

Why risk it?

Vaccination is the best way to prevent hepatitis A and B infection.

The symptoms of hepatitis A can include fever, nausea, jaundice (yellowing of the skin and whites of the eyes), loss of appetite, vomiting, abdominal discomfort, feeling unwell, dark urine and fatigue.

However, not all infected adults will experience them.

That means you could contract hepatitis A, and spread it to others, without knowing.

Hepatitis A infection can have mild to severe consequences on infected individuals that can last from a few weeks to several months.

Chronic hepatitis and carrier states are not linked with hepatitis A infection.

However, relapsing hepatitis, a condition where a person gets worse again after a period of improvement, can last up to a year in 15% of cases.

While most infected people recover, the older you are, the more severe hepatitis A can be.

Approximately 25% of infected adults are hospitalized.

The case fatality rate, the proportion of deaths per the number of people with a particular medical condition, is 0.1% to 0.3%, and can reach 1.8% in adults 50 years and older.

Why risk it?

Vaccination is the best way to prevent hepatitis A and B infection.

TWINRIX is not indicated to treat the symptoms of, or reduce the serious consequences associated with hepatitis A and B.

The symptoms of hepatitis B can include fatigue, nausea, jaundice (yellowing of the skin and whites of the eyes), loss of appetite, vomiting, abdominal discomfort, joint pain, dark urine and clay-coloured stool.

However, not all infected adults will experience them.

That means you could contract hepatitis B, and spread it to others, without knowing.

While most recover, 10% of infected adults become lifelong "carriers".

If this happens, you can pass the virus on to others for the rest of your life without having symptoms yourself.

Chronic hepatitis B may lead to cirrhosis and liver cancer.*

Why risk it?

Vaccination is the best way to prevent hepatitis A and B infection.

TWINRIX is not indicated to treat the symptoms of, or reduce the serious consequences associated with hepatitis A and B.

If you suspect that you may have been exposed to hepatitis A or B, contact your healthcare provider right away.

Why risk it?

Vaccination is the best way to prevent hepatitis A and B infection.