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 professional 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 professional 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 professional or visit your local travel clinic.
TWINRIX can be administered at the vaccination schedules shown below. Your healthcare professional 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 | Date of first dose. |
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 | Date of first dose. |
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 |
Date of first dose. |
Date of first dose. |
| 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 complete 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 professional to reschedule another visit.
Get helpful reminders.
The TWINRIX Dose Reminders service is a simple, convenient way to get timely vaccine reminders.
Sign up nowImmunization may not be suitable for everyone and can be associated with adverse events. Be sure to consult your healthcare professional 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 professional to reschedule another visit.
Get helpful reminders.
The TWINRIX Dose Reminders service is a simple, convenient way to get timely vaccine reminders.
Sign up nowImmunization may not be suitable for everyone and can be associated with adverse events. Be sure to consult your healthcare professional 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 professional 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 | Date of first dose. |
1 month after the first dose. |
6 months after the first dose. |
| Alternate schedule* TWINRIX 1.0 mL |
1-15 years | Date of first dose. |
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 professional to reschedule another visit.
Get helpful reminders.
The TWINRIX Dose Reminders service is a simple, convenient way to get timely vaccine reminders.
Sign up nowIf 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 professional.
Complete your TWINRIX doses!
You must complete 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 professional to reschedule another visit.
Get helpful reminders.
The TWINRIX Dose Reminders service is a simple, convenient way to get timely vaccine reminders.
Sign up nowIf you have missed a scheduled vaccine dose, talk to your healthcare professional 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 nowBeing 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 professional.
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 professional.
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 professionals 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 professional.
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 professional.
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 professional 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 are 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.
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 are 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.
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 overall case fatality rate, which is the proportion of deaths among the number of hepatitis A cases, is approximately 0.5%, but can reach 2.6% in adults over 60 years of age.
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 professional right away.
Why risk it?
Vaccination is the best way to prevent hepatitis A and B infection.