Administration of Final Dose of Hep B Twinrix Vaccine

Understanding Twinrix Vaccination Schedule

• The Centers for Disease Control and Prevention recommends that Twinrix is a combination vaccine that provides protection against both Hepatitis A and Hepatitis B viruses for adults aged ≥18 years 1
• The accelerated 4-dose schedule for Twinrix consists of doses at 0 day, 7 day, 21-30 day, and 12 months 2

Importance of Completing the Vaccination Series

• The Advisory Committee on Immunization Practices notes that when a hepatitis B vaccine schedule is interrupted, the series does not need to be restarted - the final dose should be administered as soon as possible 3, 4
• The final dose in the accelerated 4-dose Twinrix schedule (at 12 months) is crucial for long-term immunity and should not be omitted 2

Special Considerations for Interrupted Schedules

• For Twinrix specifically, the Advisory Committee on Immunization Practices notes that if only the final dose has been delayed, it should be administered as soon as possible 3
• The Centers for Disease Control and Prevention recommends that the 4-day grace period rule does not apply to the first 3 doses of the accelerated schedule (0, 7, 21-30 days), but the final 12-month dose should be administered as soon as possible if delayed 3, 4

Common Pitfalls to Avoid

• The Advisory Committee on Immunization Practices recommends that one should not restart the entire series if the schedule is interrupted - simply continue where it was left off 4