Twinrix Vaccination Schedule for Travelers

Initial Vaccination Series

The standard 3-dose schedule of Twinrix, administered at 0, 1, and 6 months, provides optimal long-term protection against hepatitis A and B, according to the American College of Physicians, as published in the Annals of Internal Medicine 1, 2
The accelerated 4-dose schedule of Twinrix, given on days 0, 7, 21-30, plus a booster at 12 months, is recommended for travelers needing rapid protection, as suggested by the Annals of Internal Medicine 1, 2

The Centers for Disease Control and Prevention recommends that once the primary Twinrix series is completed, no routine booster doses are needed for future travel, as vaccine-induced immunity persists for more than 30 years 2

The World Health Organization and the Centers for Disease Control and Prevention recommend that travelers to countries with high or intermediate endemicity for both hepatitis A and B should receive Twinrix, as it provides protection against both viruses 3, 4
The American College of Physicians suggests starting the first dose of Twinrix as soon as travel is considered, regardless of departure date, and considering additional immune globulin for optimal hepatitis A protection in certain individuals 3, 4, 5

The Centers for Disease Control and Prevention advises against restarting the Twinrix series if interrupted, and instead recommends continuing where you left off, as restarting wastes doses and delays protection 2
The American College of Physicians recommends not assuming revaccination is needed before each trip, as the primary Twinrix series provides decades of protection 2
The Annals of Internal Medicine suggests not giving the third dose before 16 weeks from the first dose in the standard schedule, and not skipping the 12-month booster when using the accelerated schedule, as it is critical for long-term immunity 1, 2