Adjuvanted hepatitis B vaccine effective among nonresponsive HCWs
Key takeaways:
- The response rate to the two-dose hepatitis B vaccine with CpG adjuvant among the previously nonresponsive health care workers was 91%.
- Overall, 84% percent responded to just one dose of vaccine.
A two-dose series of a hepatitis B vaccine with a CpG adjuvant resulted in a more than 90% response rate among health care workers previously classified as nonresponders, researchers found.
“Clinical studies showed superior response rates for populations that are at risk for nonresponse — adults aged 40 years and older and individuals with type 2 diabetes,” Mary S. Hayney, PharmD, MPH, professor of pharmacy at the University of Wisconsin School of Pharmacy, told Healio.
“Our health care worker nonresponders have already shown themselves to be nonresponders to hepatitis B vaccines with aluminum adjuvant so response to the hepatitis B vaccine with CpG adjuvant should be systematically studied in this challenging population,” she said.
Hayney and colleagues conducted a prospective open-label study to measure the response rate to the HepB-CpG series in health care workers. Workers were enrolled if they had received at least five doses of vaccine, were had levels of hepatitis B antibodies lower than 10 mIU/mL and had no evidence of hepatitis B infection in their employee health services medical records.
After screening for vaccine contraindications and hepatitis B vaccine nonresponse, risk factors such as age, sex, smoking status, diabetes and immunosuppression, the nonresponders received a dose of HepB-CpG by intramuscular injection, followed by a second dose 28 to 42 days later. They then underwent blood draws for hepatitis B antibodies 28 to 42 days after the first and second dose.
Overall, the study demonstrated that after two doses of HepB-CpG, 43 of 47 health care workers (91%) responded, whereas 41 of 49 health care workers (84%) responded after one dose. Among the 29 health care workers with risk factors for nonresponse, 25 (86%) were responsive.
Additionally, the researchers noted that the vaccine series was generally well tolerated, with 37% of recipients reporting soreness at the injection site.
“Immunizers should consider using hepatitis B vaccine with CpG adjuvant for health care workers who are known nonresponders — defined as those who received at least five doses of hepatitis B vaccine with aluminum adjuvant and are documented to have an antibody response that is considered below the immune threshold,” Hayney concluded.
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