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Hastings and Prince Edward Public Health

Hepatitis A & B Vaccine (Twinrix) FAQs

The combined Hepatitis A & B vaccine helps to protect children and adults against liver infections caused by both viruses.

What is Hepatitis A?

  • Hepatitis A is a highly contagious liver infection caused by the hepatitis A virus. It interferes with the liver’s ability to digest food and help to remove waste products from your body.
  • Hepatitis A is most common in developing countries where there may be poor food handling and storage and inadequate water sanitation.
  • The virus spreads easily by eating contaminated food or drinking contaminated water or through direct contact with an infected individual.
  • Some people with hepatitis A have no symptoms, especially children under 5 years of age.
  • If you do have symptoms, they will appear 2 to 7 weeks after becoming infected and may include feeling unwell with fever, nausea and vomiting, followed by jaundice, which is a yellowing of the skin and whites of the eyes.
  • Most people recover completely after 4 to 6 weeks and become immune to the infection; however, some people, especially the elderly and those with chronic liver problems, can develop serious health problems.
  • There is no medication to treat or cure hepatitis A.

What is Hepatitis B?

  • Hepatitis B is a highly contagious liver infection caused by the hepatitis B virus
  • The virus is a worldwide health problem; it is not spread through the air, food or water.
  • Hepatitis B spreads when the blood or body fluids (semen, saliva, vaginal fluids, breast milk) from an infected person pass into the body of someone else, for example, through sexual intercourse, blood transfusions or needle stick injuries.
  • The virus can live on surfaces for several days, so it can also spread through shared needles, razors, toothbrushes or unclean piercing or tattooing equipment.
  • Some people do not even know that they have hepatitis B while others may have symptoms that include loss of appetite, abdominal discomfort, nausea and vomiting and jaundice.
  • Most people recover from hepatitis B, but some become chronic carriers of the virus.
  • There is no medication to treat or cure hepatitis B.

Who should get the Hepatitis A & B vaccine, Twinrix®?

  • Individuals of all ages, who are at risk of infection with hepatitis A & B, including those who
    • plan to travel to international areas with moderate to high rates of hepatitis A & B
    • have long-term (chronic) liver disease
    • use illegal injectable drugs
    • are men who have sex with men; have multiple sex partners
    • work in occupations that expose them to viruses, such as some lab workers
    • have clotting factor disorders and receive blood products, e.g. haemophiliacs
    • have household or sexual contact with / are frequently exposed to an infected individual
    • come from, or are living in, a community where the rate of hepatitis A or B is high

Who should not get the Hepatitis A & B vaccine?

  • Anyone who has had a serious allergic reaction to this vaccine in the past, or to any component of Twinrix® -19 yrs of age and older; Twinrix® Junior –1 to 18 yrs of age; Twinrix® rapid schedule –19 yrs of age and older; Twinrix® -1 to 15 yrs of age
    • all four vaccines contain yeast proteins, aluminum hydroxide, aluminum phosphate, sodium chloride, amino acids, formaldehyde, neomycin sulphate, polysorbate 20
  • Anyone with a high fever or moderate to severe illness should wait until they feel well.
  • Pregnant or breastfeeding women should be vaccinated only when clearly needed.

What are the common side effects of the Hepatitis A & B vaccine?

  • Some people may feel sore and swollen for a few days where the needle was given, have a slight fever or feel tired for a day or two.
  • Tylenol® or ibuprofen may be taken afterwards, as directed, to reduce discomfort or fever.
  • Children under 19 years of age must not be given ASA, Aspirin® or salicylates.

What else do I need to know?

  • The Twinrix® 19 yrs of age and older / Twinrix® Junior dosing schedule involves boosters at 1 and 6 months after the first dose; over 95% of people are protected against hepatitis A & B one month after the second dose.
  • For Twinrix® ages 1 to 15 yrs, there is a single booster 6 to 12 months after the first dose.
  • If you are travelling within one month of starting the series, the Twinrix® rapid dosing schedule may be followed, with 3 boosters given at 7, 21 days and 12 months after the first dose; one week after the third dose, almost everyone is protected against hepatitis A and over 80% against hepatitis B.
  • When you complete the Twinrix® series,your protection will likely last for at least 20 years for hepatitis A and lifelong for hepatitis B.
  • The best defense against germs is frequent hand washing; wash your hands with soap and water for at least 15 seconds or use alcohol-based hand sanitizers.
  • Follow the advice on the Safe Food and Safe Water fact sheets.

When should I seek medical attention after immunization?

  • If you or your child experiences any unusual side effects, seek medical attention and notify us.
  • Go to Emergency at a hospital right away or call 911 if you or your child has any of the following after immunization:
    • swelling of the face and neck
    • problems breathing
    • hives and itchy, reddened skin

Your Record of Protection

After you receive any immunization, make sure your health care provider updates your personal immunization record. Keep it in a safe place. Please inform us of any immunizations not received from Public Health.

Hepatitis A & B Vaccine (Twinrix®) Fact Sheet printable pdf

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COVID-19 vaccines in HPE

Eligible individuals can receive their vaccination at many participating local pharmacies by contacting the pharmacy directly. Please visit covid-19.ontario.ca/vaccine-locations for location and registration information.

Vaccine ordering for health care providers

Vaccine orders for routine immunizations and STI medications continue to be available through HPEPH by using our vaccine order forms; however, please note that our vaccine delivery/pickup procedure has changed. For the most up to date pick up schedule please visit hpePublicHealth.ca/vaccine-orders-info-healthcare-providers/.