title: The underestimated risk of hepatitis A and hepatitis B: benefits of an accelerated vaccination schedule.
abstract: Hepatitis A virus (HAV) and hepatitis B virus (HBV) are vaccine-preventable. Current recommendations advocate vaccination of non-immune adults at risk of exposure, including travelers to HAV or HBV endemic areas, individuals with high risk of contracting a sexually transmitted infection, and some correctional facility inmates. We review the use of an accelerated schedule to administer the combination hepatitis A and hepatitis B vaccine (Twinrix). Administering three doses over three weeks and a fourth at 12 months provides rapid initial protection of most individuals for whom the standard 6-month vaccination schedule would not be suitable, including last-minute travelers and short-term correctional facility inmates. Furthermore, we consider the role of a universal vaccination strategy in preventing the spread of HAV and HBV.
authors.affiliation: Division of Infectious Disease, Department of Medicine, Tropical Disease Unit, Toronto General Hospital, University of Toronto, Toronto, Ontario M5G 2C4, Canada. jay.keystone@utoronto.ca
authors.forename: Jay S
authors.initials: JS
authors.lastname: Keystone
authors.forename: Jody H
authors.initials: JH
authors.lastname: Hershey
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D014943:Global Health; D006506:Hepatitis A / Q000453:epidemiology / Q000517:prevention & control*; D022362:Hepatitis A Vaccines / Q000008:administration & dosage*; D006509:Hepatitis B / Q000453:epidemiology / Q000517:prevention & control*; D017325:Hepatitis B Vaccines / Q000008:administration & dosage*; D006801:Humans; D007115:Immunization Schedule; D015995:Prevalence; D011329:Prisoners; D016036:Seroepidemiologic Studies; D014195:Travel; D017778:Vaccines, Combined / Q000008:administration & dosage*
chemical_list: D022362:Hepatitis A Vaccines; D017325:Hepatitis B Vaccines; D017778:Vaccines, Combined; C433226:twinrix