The availability of accelerated schedules of vaccination, as well as the development of
combination vaccines, has enhanced the methods of protection against
infectious disease, in particular that of
hepatitis A and B viruses. The benefits of using accelerated schedules include: (i) enhanced adherence to and subsequent completion of
vaccine courses; (ii) convenience for the recipient of the
vaccine; (iii) reduced administration costs of providing the
vaccine; and, most importantly, (iv) the ability to provide protection against these serious
infections to those who will be imminently exposed to the risk and so require protection as quickly as possible. Active immunisation against both
hepatitis A and B viruses has only been recognised within the last 20 years. During this time clinical studies have demonstrated the safety and efficacy of administering the monovalent
hepatitis B vaccine by way of accelerated schedules. There are now several accelerated schedules of administration of
hepatitis B vaccine which can be tailored to the needs of the individual at risk of exposure to
infection. One such schedule allows the primary course to be administered within a period of 1 month. This schedule of day 0, 7 and 21, with a booster at 12 months, is licensed for use with the recombinant
hepatitis B vaccine Engerix B and results in a seroprotection rate of 65% at day 28 which increases to 99% at month 13. In more recent years, the development of a multivalent or combination
vaccine against
hepatitis A and B (
Twinrix) has been a welcome advance in the protection against viral
hepatitis, and has been of particular benefit to those who are at risk of
infection with both viruses. The advantages of accelerated schedules have also been recognised with this combination
vaccine. The primary course may be administered within a period of 1 month so providing protection for those at risk and, in particular, the last minute traveller.