In its 2006 ACIP recommendation for the prevention of hepatitis B, an accelerated 4-dose series of hepatitis B vaccine (which was not FDA-approved) was described as acceptable. CDC experts no longer recommend that approach when travel is imminent because other FDA-approved options exist.
The simplest option is Heplisav-B: its 2-dose series may be completed in 4 weeks. If Heplisav-B is unavailable, another option is to give the first 3 doses of the 4-dose accelerated schedule for Twinrix (HepA-HepB) at 0 days, 7 days, and 21-30 days and to have her return for a fourth dose 12 months after dose 1. Although this patient does not need the hepatitis A component, a combination vaccine such as Twinrix may be used if a single antigen option is not feasible; the additional doses of hepatitis A vaccine are not harmful.