Comparing Hepatitis B Vaccine Boosters for Seropositivity in US Healthcare Workers

TL/DR –

The study conducted on 242 US healthcare workers compared standard Hepatitis B vaccines with Heplisav-B as a single booster for previously vaccinated individuals. The results showed that a single booster achieved seropositivity for 92.7% of the standard Hepatitis B vaccine group and 99.4% of the Heplisav-B group, suggesting a single booster could be reasonable for young, healthy healthcare workers who never showed seropositivity. However, the researchers acknowledged that further studies are needed to confirm these results in other populations and determine whether the increased effectiveness of Heplisav-B justifies its higher cost.

Hepatitis B Seroprotection in US Health Care Workers

We examined the efficacy of Heplisav-B (Dynavax Technologies Corp) versus standard hepatitis B vaccines as a single booster for young, previously vaccinated health care workers. Out of 242 participants, 92.7% in the standard hepatitis B vaccine group and 99.4% in the Heplisav-B group achieved seropositivity after one booster.

Increased Risk of Hepatitis B Infection in Health Care Workers

US health care workers, including trainees, face an increased risk of hepatitis B infection through accidental exposure to blood or body fluids. Standard vaccinations include Recombivax HB, Engerix-B, and Twinrix, which are typically administered in a 3-dose series during childhood. Heplisav-B, a new vaccine approved in 2017, contains an immune adjuvant, synthetic cytosine-phosphate-guanine oligonucleotide (CpG 1018).

Study Design and Methodology

We performed a retrospective cohort study by reviewing health records of individuals in the doctor of medicine program at the Uniformed Services University of the Health Sciences from 2019 to 2022. Students were classified based on their initial postvaccination anti-HBs test, with those potentially susceptible and who had a full hepatitis B vaccine series categorised into two groups according to the vaccine received as a booster dose.

Results of the Study

A total of 242 students who tested nonseropositive, completed a previous vaccination series and received a single booster vaccination were included in the study. A single booster resulted in 92.7% of individuals in the standard hepatitis B vaccine group and 99.4% in the Heplisav-B group meeting the US Centers for Disease Control and Prevention threshold for protection for health care workers.

Discussion on the Findings

Both groups displayed a high response rate to a single booster dose of hepatitis B vaccine. An absolute increase of 6.7% in the proportion at anti-HBs ≥10 mIU/mL after a single booster suggests that vaccinating 15 individuals with Heplisav-B rather than standard vaccine could result in one more person being seropositive. However, the study faced limitations such as the inability to consider factors like gender, race, or exact age at vaccination. More research is needed to determine if Heplisav-B’s effectiveness justifies its increased per-dose cost.

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