In 2001, the FDA approved a combination of hepatitis A and hepatitis B vaccine marketed as the trade name Twinrix. This combination allows adults to receive protection against both forms of hepatitis with three injections instead of five. Hepatitis B vaccine is also present in PEDIARIX and Engerix-B combination vaccines.

The hepatitis B vaccine protects against infection with the hepatitis B virus. Everyone who is under 18 years of age should get hepatitis B vaccine. Unimmunized children younger than 18 years may begin the series at any age. Adults should get the hepatitis B vaccine if they are at risk for infection.

Indications for use

• Dialysis nurses
• Dialysis patients
• Health care workers
• Infants with hepatitis B infected mothers
• Institutionalized patients
• Intravenous drug users
• Male homosexuals.
• Sexually promiscuous persons
• Geographical area; your risk is also higher if your parents were born in:
• Southeast Asia
• Africa
• Amazon Basin in South America
• Pacific Islands
• Middle East

Those who have had a serious reaction to baker's yeast in the past should not receive this vaccine.

Administration
Complete immunity to hepatitis B virus will require the administration of three boosters:

• In most cases the first booster may administered anywhere from birth to through the second month of life. Infants born to hepatitis B infected mothers should receive vaccine and 0.5 mL of hepatitis B immune globulin (HBIG) within 12 hours of birth at separate sites.
• The second booster should be administered at least one month after the first dose. Infants born to hepatitis B infected mothers should receive the second dose at least one month after the first dose.
• The third booster should be given at least 2 months after the second, but not before six months of age. Infants born to hepatitis B infected mothers should receive their third dose at least four months after the first and two months after the second, but not before 6 months of age.
• Illness may require a shot to be delayed. Only your doctor can make this determination.

Side Effects
Mild problems:

• Soreness at the vaccination site (1 out of 11 children)
• Mild to moderate fever ( 1 out of 14 children)

Severe problems:

• Serious allergic reactions are very rare. Signs of a serious allergic reaction can include difficulty breathing, hoarseness or wheezing, hives, paleness, weakness, a fast heart beat or dizziness.