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Hepatitis A & B Vaccine (Twinrix®)
What is hepatitis A?
• Hepatitis A is an infection of the liver caused by the
hepatitis A virus.
• It is spread by eating or drinking food or water
contaminated with human feces.
• Symptoms can include lack of appetite, nausea, tiredness,
fever and jaundice.
• About 25% of people with hepatitis A require
hospitalization.
• Less than 1 out of 1000 people with hepatitis A die.
What is hepatitis B?
• Hepatitis B is an infection of the liver caused by hepatitis B
virus.
• It is spread by blood, saliva, semen and vaginal fluids.
• About 1%-2% of people with acute hepatitis B will die.
• Some infected people become chronic carriers (less
than10% of adults; 25%-50% of young children, 90%-
95% of infants).
• About 15%-25% of chronic carriers will die from liver
cancer or cirrhosis.
• Chronic infection may lead to liver cancer and/or death.
What does Hepatitis A & B
vaccine contain?
• Hepatitis A and B vaccine contains neomycin,
formaldehyde, aluminum salts, polysorbate 20, thimerosal,
2-phenoxyethanol and yeast.
• The connection between the needle and the syringe (in
the pre-filled syringe) contains latex.
Who should receive the vaccine?
• All international travellers should be protected against
hepatitis B.
• All travellers (over the age of 1 year) to developing
countries should be protected against hepatitis A.
• People with bleeding disorders.
• People who have HIV.
• People with chronic liver disease.
• Personnel and residents of institutions for mentally
challenged individuals.
• People with a lifestyle or occupational risk.
• Transplant recipients/candidates.
• People who have hepatitis C.
• Children <7 years whose families have immigrated to
Canada from countries where hepatitis B is common.
• Hemodialysis patients and pre-dialysis (chronic, renal
failure).
• Men who have sex with men.
Who should not receive the
vaccine?
• Infants under one year of age.
• People with moderate to severe illness may have to delay
immunization.
• Use with caution in breastfeeding mothers.
• Anyone who has had a life-threatening allergic reaction to
any component of the vaccine.
When should the vaccine be
given?
• A series of three doses, with the second dose given at
least 1 month after the first and the third dose given at
least 6 months after the first
• Hepatitis A + B vaccine may be safely given with other
vaccines.
How is the vaccine given?
• By injection into a muscle.
How effective is the vaccine?
• About 88% of people (18-50 years) develop antibodies 2
weeks after 2nd dose.
• About 96% of people (18-50 years) develop antibodies 1
month after 2nd dose.
• Nearly 100% of people develop antibodies within one
month after receiving the 3rd immunization.
How long does the protection last?
• At least 20 years for hepatitis A and at least 15 years for
hepatitis B.
• Recent studies suggest recipients will enjoy lifetime
protection once the series is complete.
What might be felt after receiving the vaccine?
Very Common (> 1/10)
- Headache, fatigue, pain and redness at injection site.
Common (> 1/100 and < 1/10)
- Diarrhea, nausea, vomiting, swelling at injection site.
Uncommon (> 1/1,000 and < 1/100)
- Upper respiratory tract infection, fever, dizziness, muscle aches.
Rare (> 1/10,000 and < 1/1,000)
- Lymph disorders, rash, itchy, joint pain, nerve disorders.
Very Rare (< 1/10,000)
Call the number below if you have severe or unusual reactions.
For more information call Public Health Services at (306) 655-4780.
© 2008, Saskatoon Health Region. Reproduced only by permission.
(Updated January 4, 2010)
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