title: A new accelerated vaccination schedule for rapid protection against hepatitis A and B.
abstract: BACKGROUND
  Increasing travel stresses the requirement for rapid protection against infections such as hepatitis A and B.
  
  
  METHODS
  This randomised, multicentre study investigated an accelerated vaccination schedule using a combined hepatitis A and B vaccine (Twinrix, Smithkline Beecham Biologicals) compared with simultaneous administration of the two corresponding monovalent vaccines. The combined vaccine was administered on days 0, 7 and 21, whereas the comparison group received hepatitis A vaccine on day 0 and hepatitis B vaccine on days 0, 7 and 21. All subjects received booster vaccination at month 12.
  
  
  RESULTS
  At month 1, 100% of subjects in the combined group and 99% of the controls were seropositive for anti-HAV antibodies. The corresponding seroprotection rates for anti-HBs antibodies were 82.0 and 83.9%, respectively. Examination of the 95% confidence intervals (CIs) for the treatment differences showed the two vaccines to be equivalent in terms of immunogenicity 1 week after the initial vaccination course. Just prior to the booster, the seropositivity rate for anti-HAV was 96.2% in the combined group and 95% in the control group. For anti-HBs, this was 94 and 91.6%, respectively. All subjects were seropositive for anti-HAV and seroprotected against hepatitis B at month 13. The anti-HAV GMCs were 9571mIU/ml with the combined vaccine and 5206mIU/ml in control subjects. The anti-HBs titre was 26002 and 29,196mIU/ml, respectively. Both groups had a similar reactogenicity profile.
  
  
  CONCLUSIONS
  The accelerated schedule of the combined vaccine provides a good immune response against hepatitis A and B antigens and is suitable for last minute immunisation.
authors.affiliation: Department of Infectious Diseases and Tropical Medicine, Ludwig-Maximilians-Universitaet Muenchen, Leopoldstrasse 5, 80802, Munich, Germany. nothdurft@lrz.uni-muenchen.de
authors.forename: H D
authors.initials: HD
authors.lastname: Nothdurft
authors.forename: M
authors.initials: M
authors.lastname: Dietrich
authors.forename: J N
authors.initials: JN
authors.lastname: Zuckerman
authors.forename: J
authors.initials: J
authors.lastname: Knobloch
authors.forename: P
authors.initials: P
authors.lastname: Kern
authors.forename: J
authors.initials: J
authors.lastname: Vollmar
authors.forename: R
authors.initials: R
authors.lastname: Sänger
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006506:Hepatitis A / Q000517:prevention & control*; D035922:Hepatitis A Antibodies; D022362:Hepatitis A Vaccines / Q000276:immunology*; D006508:Hepatitis Antibodies / Q000097:blood; D006509:Hepatitis B / Q000517:prevention & control*; D006510:Hepatitis B Antibodies / Q000097:blood; D017325:Hepatitis B Vaccines / Q000276:immunology*; D006801:Humans; D007115:Immunization Schedule; D008297:Male; D008875:Middle Aged
chemical_list: D035922:Hepatitis A Antibodies; D022362:Hepatitis A Vaccines; D006508:Hepatitis Antibodies; D006510:Hepatitis B Antibodies; D017325:Hepatitis B Vaccines