I did find a CDC reference that allows Heplisav-B for booster dose.  See https://www.cdc.gov/mmwr/volumes/67/wr/mm6715a5.htm.   “HepB-CpG may also be used to revaccinate new health care personnel (including the challenge dose) initially vaccinated with a vaccine from a different manufacturer in the distant past who have anti-HBs <10 mIU/mL upon hire or matriculation (2).”  The advantage of Heplisav-B for challenge is that if still negative after booster, the series can be finished more quickly.  There is also the unproven hope that the Heplisav may be better at getting the desired result than the engerix.  Best, Tim

 

Tim Crump, MSN, FNP

Tim Crump, MSN, FNP

Family Nurse Practitioner

Multnomah Pavilion 1 SE, Suite 1110

Occupational Health

Healthcare Human Resources

 

Oregon Health & Science University

3181 SW Sam Jackson Park Rd

Mail code: UHN 89

Portland, OR 97239-3098

Department Phone: 503-494-5271

Office Phone: 503-346-1152

Fax: 503-494-4457

Email: crumpt@ohsu.edu

 

 

 

From: MCOH-EH [mailto:mcoh-eh-bounces@mylist.net] On Behalf Of Higazi, Patricia
Sent: Wednesday, August 21, 2019 8:19 AM
To: MCOH-EH <mcoh-eh@mylist.net>
Subject: Re: [MCOH-EH] Can Heplisav-B be used for booster dose?

 

Yes our previous rate of conversion was 68% albeit over many more employees.

 

Patricia Higazi  MSN RN COHN

Occupational Health Director

Children’s Hospital of The King’s Daughters

Norfolk, Virginia 23507

Tel: 757 668 7852

Fax: 757 668 8775

 

 

 

From: MCOH-EH [mailto:mcoh-eh-bounces@mylist.net] On Behalf Of Cockrum, MD David S
Sent: Wednesday, August 21, 2019 11:05 AM
To: MCOH-EH
Subject: Re: [MCOH-EH] Can Heplisav-B be used for booster dose?

 

External:

 

Patricia-

 

Did you measure a positive titer rate using the previous version of HBV vaccine as booster to compare to your success rate with Hepislav?

 

David

 

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MD

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From: MCOH-EH [mailto:mcoh-eh-bounces@mylist.net] On Behalf Of Higazi, Patricia
Sent: Wednesday, August 21, 2019 10:00 AM
To: MCOH-EH <mcoh-eh@mylist.net>
Subject: Re: [MCOH-EH] Can Heplisav-B be used for booster dose?

 

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No just one , titer 6 weeks later 56 of 58 were positive

 

From: MCOH-EH [mailto:mcoh-eh-bounces+higazipj=chkd.com@mylist.net] On Behalf Of Tara Dockery
Sent: Wednesday, August 21, 2019 10:58 AM
To: MCOH-EH
Subject: Re: [MCOH-EH] Can Heplisav-B be used for booster dose?

 

External:

 

Patricia when you booster them do you give both doses?

 

Tara

 

From: MCOH-EH [mailto:mcoh-eh-bounces@mylist.net] On Behalf Of Higazi, Patricia
Sent: Wednesday, August 21, 2019 6:53 AM
To: MCOH-EH <mcoh-eh@mylist.net>
Subject: Re: [MCOH-EH] Can Heplisav-B be used for booster dose?

 

We have been using Heplisav for titer negative employees since October last year – so far 98.2 % positive titers post booster (58 ee)

 

Patricia Higazi  MSN RN COHN

Occupational Health Director

Children’s Hospital of The King’s Daughters

Norfolk, Virginia 23507

Tel: 757 668 7852

Fax: 757 668 8775

 

 

 

From: MCOH-EH [mailto:mcoh-eh-bounces@mylist.net] On Behalf Of Kim.Norton2@hcahealthcare.com
Sent: Wednesday, August 21, 2019 8:37 AM
To: mcoh-eh@mylist.net
Subject: Re: [MCOH-EH] Can Heplisav-B be used for booster dose?
Importance: High

 

External:

 

Hi Tim,

Per the MMWR / January 12, 2018 / Vol. 67 / No. 1 US Department of Health and Human Services/Centers for Disease Control and Prevention.

https://www.cdc.gov/mmwr/volumes/67/rr/pdfs/rr6701-H.PDF

 

“Response to Revaccination”

A challenge dose of HepB vaccine may be used to determine the presence of vaccine-induced immunologic memory through generation of an anamnestic response. The term “booster dose” has been used to refer to a dose of HepB vaccine administered after a primary vaccination series to provide” (page 12, bottom right).

 

We utilize this method and have found that the majority will convert to immunity status.

However, we use the Engerix Hep B (01 ml). After booster vaccination, we schedule a Titer retest 6 – 8 weeks later

 

Thank you,

Kim A. Norton, B.S.N., R.N., O.H.N.

Occupational Health Services & Injury Coordinator

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From: MCOH-EH <mcoh-eh-bounces@mylist.net> On Behalf Of Tim Crump
Sent: Tuesday, August 20, 2019 3:08 PM
To: MCOH-EH <mcoh-eh@mylist.net>
Subject: {EXTERNAL} [MCOH-EH] Can Heplisav-B be used for booster dose?

 

We are transitioning over to mostly Heplisav-B for our Hep B vaccinations.  Does anyone have thoughts whether Heplisav-B can be used for a booster dose?  (For example, if a worker had a full documented Hep B series in 2001, but never got a titer till now and it is negative, can we use one Heplisav-B for booster dose, and if the worker has a positive titer after, call them long-term immune?) 

·         Our drug rep says no, that Heplisav is always given as a series of 2 and never as a single dose. 

 

·         To my mind though, anyone with a full Hep B series and a subsequent positive titer has long term immunity, and it shouldn’t matter which vaccine boosts to demonstrate this.

 

What do others think?  The advantage of boosting w/ Heplisav-B would be that if the titer is negative, it would take a lot less time to complete the second series.  Best, Tim

 

 

Tim Crump, MSN, FNP

Tim Crump, MSN, FNP

Family Nurse Practitioner

Multnomah Pavilion 1 SE, Suite 1110

Occupational Health

Healthcare Human Resources

 

Oregon Health & Science University

3181 SW Sam Jackson Park Rd

Mail code: UHN 89

Portland, OR 97239-3098

Department Phone: 503-494-5271

Office Phone: 503-346-1152

Fax: 503-494-4457

Email: crumpt@ohsu.edu

 

Mon-Fri, 7:30-4:00

 

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