What if a patient doesn’t come back until day 80 when they should have received the third dose of Twinrix accelerated at day 21-30?
We have no data on how to manage a person who starts on the newly-approved 4-dose schedule and has a lapse in the schedule. But if exposure were still imminent it would seem reasonable to simply continue the series from where it was interrupted. On the other hand, if the lapse occurs after the FIRST dose of the new schedule, and the second dose can be administered according to the STANDARD schedule, 1 to 2 months after the first dose, we suggest reverting to the standard schedule of either Twinrix or single-antigen vaccine.
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