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Hepatitis a adult vaccine / hepatitis b adult vaccine Side Effects

For the Consumer

Applies to hepatitis a adult vaccine / hepatitis b adult vaccine: intramuscular suspension

Along with its needed effects, hepatitis a adult vaccine/hepatitis b adult vaccine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur while taking hepatitis a adult vaccine/hepatitis b adult vaccine:

More Common

  • Fever more than 99.5 degrees F
  • unusual tiredness or weakness


  • Difficulty with breathing or swallowing
  • hives
  • itching, especially of the hands or feet
  • reddening of the skin, especially around the ears
  • swelling of the eyes, face, or inside of the nose
  • unusual tiredness or weakness (sudden and severe)

Incidence Not Known

  • Agitation
  • back pain
  • being forgetful
  • black, tarry stools
  • bleeding gums
  • blistering, peeling, or loosening of the skin
  • blood in the urine or stools
  • bloody nose
  • blurred vision
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • chills
  • coma
  • confusion
  • convulsions or seizures
  • cough
  • dark urine
  • diarrhea
  • difficulty controlling your bladder or bowels
  • difficulty with walking
  • dizziness
  • drowsiness
  • fast, irregular, pounding, or racing heartbeat or pulse
  • feeling of discomfort
  • feeling sad or depressed
  • general feeling of illness
  • general tiredness and weakness
  • hallucinations
  • headache
  • heavier menstrual periods
  • inability to move the arms and legs
  • increased sweating
  • inflammation of the joints
  • irritability
  • itching
  • joint or muscle pain
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • light-colored stools
  • muscle aches or cramps
  • nausea or vomiting
  • numbness or tingling in your arms, face, hands, or legs
  • partial or slight paralysis
  • pinpoint red spots on the skin
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • rash
  • red, irritated eyes
  • redness, soreness, or itching skin
  • severe headache
  • shortness of breath
  • slurred speech or problems with swallowing
  • sore throat
  • sores, ulcers, or white spots in the mouth or on the lips
  • sores, welting, or blisters
  • stiff neck or back
  • sudden numbness and weakness in the arms and legs
  • swollen lymph glands
  • tightness in the chest
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • upper right abdominal or stomach pain
  • wheezing
  • yellow eyes and skin

Some side effects of hepatitis a adult vaccine / hepatitis b adult vaccine may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More Common

  • Body aches or pain
  • ear congestion
  • hard lump, redness, soreness, or swelling at the injection site
  • loss of voice
  • nasal congestion
  • runny nose
  • sneezing


  • Abdominal or stomach pain
  • bruising at the injection site
  • dry mouth
  • fainting or lightheadedness when getting up suddenly from a lying or sitting position
  • feeling of constant movement of self or surroundings
  • feeling of warmth
  • headache, severe and throbbing
  • hyperventilation
  • large, flat, blue or purplish patches in the skin at the injection site
  • loss of appetite
  • muscle pain or stiffness
  • pain, swelling, or redness in the joints
  • redness of the face, neck, arms, and occasionally, upper chest
  • restlessness
  • sensation of spinning
  • shaking
  • sleepiness or unusual drowsiness
  • sleeplessness
  • small, red or purple spots on the skin
  • sweating
  • trouble with sleeping
  • unable to sleep
  • unusually fast heartbeat
  • unusually warm skin
  • weakness
  • weight loss

Incidence Not Known

  • Acid or sour stomach
  • belching
  • continuing ringing or buzzing or other unexplained noise in the ears
  • disturbed color perception
  • double vision
  • earache
  • hair loss or thinning of the hair
  • halos around lights
  • hearing loss
  • heartburn
  • indigestion
  • night blindness
  • overbright appearance of lights
  • painful blisters on the trunk of the body
  • stomach discomfort or upset
  • tunnel vision
  • weakness of the muscles in your face

For Healthcare Professionals

Applies to hepatitis a adult vaccine / hepatitis b adult vaccine: intramuscular suspension


Hepatitis A-hepatitis B vaccine is generally well-tolerated. Most side effects were mild, self-limiting, and of short duration (less than 48 hours).[Ref]


Local side effects have included soreness, redness, swelling, induration, pruritus, and ecchymosis at the injection site.[Ref]


Other side effects have included headache, fatigue, fever, sweating, weakness, flushing, influenza-like symptoms, tingling, tinnitus, and earache.[Ref]


Cardiovascular side effects have included syncope, hypotension, tachycardia, and palpitations.[Ref]


Dermatologic side effects have included rash, urticaria, petechiae, erythema, hyperhidrosis, angioedema, eczema, herpes zoster, erythema nodosum, and alopecia.[Ref]


Gastrointestinal side effects have included diarrhea, nausea, vomiting, abdominal pain, anorexia, constipation, dysgeusia, and dyspepsia.[Ref]


Hematologic side effects have included lymphadenopathy and thrombocytopenia.[Ref]


Hepatic side effects have included jaundice, hepatitis, and abnormal liver function tests.[Ref]


Hypersensitivity reactions have included anaphylaxis, anaphylactoid reactions, erythema multiforme, Stevens-Johnson syndrome, angioedema, arthritis, and serum-sickness-like syndrome (arthralgia, arthritis, fever, urticaria, erythema multiforme, ecchymoses, and erythema nodosum).[Ref]


Musculoskeletal side effects have included arthralgia, myalgia, back pain, and creatine phosphokinase elevations.[Ref]

Nervous system

Nervous system side effects have included migraine, paresthesia, vertigo, somnolence, insomnia, irritability, agitation, dizziness, hypertonic episode, convulsions, paresis, encephalopathy, neuropathy, myelitis, Guillain-Barre syndrome, multiple sclerosis, Bell's palsy, and transverse myelitis.[Ref]


Ocular side effects have included photophobia, optic neuritis, conjunctivitis, keratitis, and visual disturbances.[Ref]


Respiratory side effects have included upper respiratory tract infections, dyspnea, bronchospasm, and asthma-like symptoms.[Ref]


1. "Product Information. Twinrix (hepatitis A-hepatitis B vaccine)" SmithKline Beecham, Philadelphia, PA.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.