COLUMBUS COUNTY HEALTH DEPARTMENT
TWINRIX POLICY
Policy Title:
Twinrix Policy
Program Area:
All Clinical Areas
Policy Identifier:
(optional)
Effective Date:
Approval Date:
Revision
Date(s):
Approved by:
Kim Smith RN, BSN, MSHCA, Health Director
Approved by:
Hilda Memory RN, BS, MSHA, Director of Nursing
1/2/2004
8/18/08, 9/21/2010
Purpose:
The purpose of this policy is related to the availability of Twinrix vaccine to local health
departments effective January 2, 2004. Twinrix, manufactured by GlaxoSmith Kline, is a hepatitis
A and hepatitis B combination vaccine for use in persons > 18 years of age and older. The Center
of Disease Control and Prevention in Atlanta recommend this vaccine for certain high risk
populations.
Definitions:
Columbus County Health Department will make available State Supplied Twinrix Vaccine
Administration and administer in accordance to eligibility criteria.
Responsibilities:
Public Health Nurse(s)
Procedures:

It is administered in a three dose series, by the same schedule as single-antigen hepatitis
B vaccine for adults.
o
The first dose is administered
o
The second dose is administered one month later.
o
The third dose is administered 6 months after the first dose or 5 months after the
second dose.
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COLUMBUS COUNTY HEALTH DEPARTMENT
TWINRIX POLICY

The state supplied Twinrix is packaged as five single dose safety Tip Lock syringes without
needles. You will need to purchase needles for use with this product.
Eligibility:

Twinrix vaccine is available only for local health departments. Individuals eligible for state
supplied Twinrix vaccine are defined as > 18 years of age who present to the local health
department for any reason with any of the following risk factors:
o
Men who have sex with men,
o
IV drug users,
o
Persons with multiple sex partners,
o
Any person who has been incarcerated,
o
Persons who are hepatitis C or HIV positive,
o
Persons with chronic liver disease, including persons with chronic HBV/HCV
infections who have evidence of chronic liver disease, or
o
Persons seeking treatment for STD.
Contraindications:

Hypersensitivity to any component of the vaccine, including yeast and neomycin, is a
contraindication. This vaccine is contraindicated in patients with previous hypersensitivity
to TWINRIX or monovalent hepatitis A or hepatitis B vaccine.
Precautions:

A moderate or severe acute illness is sufficient reason to postpone vaccination.

TWINRIX should be administered with caution to people on anticoagulants, and those with
thrombocytopenia or a bleeding disorder since bleeding may occur following intramuscular
administration.

As with any parenteral vaccine, epinephrine injection (1:1000) and other appropriate agents
used for the control of immediate allergic reactions must be immediately available should
an acute anaphylactic reaction occur?
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COLUMBUS COUNTY HEALTH DEPARTMENT
TWINRIX POLICY
Adverse Reactions:

See package insert
http://www.twinrix.com/risk-side-effects.html
Patient Teaching:
Patients should be informed of the benefits and risk of immunization with TWINRIX, and of
the importance of completing the immunization series.
For further information refer to the following website:
http://www.cdc.gov/vaccines/pubs/ACIP-list.htm
Laws and Rules:
Reference(s):
CDC.gov
GlaxoSmith Kline
Reformatted 2010
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