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

DAVID

COCKRUM

,

MD

Physician

Faith Regional Physician Services

Occupational Health

(402) 844 8300

2024 Pasewalk Avenue, Suite 2

,

Norfolk

,

NE

68701

Click on the logos to learn more about our services.

This message and any attachments are confidential, may contain privileged or legally protected communications or information, and are intended solely for the recipient named above. If you are not the intended recipient, you are notified that any review, distribution, dissemination or copying of this message or any attachment is prohibited. If you have received this message in error, you should immediately notify the sender by a return e-mail and delete the message from your computer system.

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?

This email originated from outside of the organization. Do not click links or open attachments unless you recognize the sender and know the content is safe. If you suspect the content of this email is malicious, please forward the email to abuse@frhs.org .

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

It is better to prevent disease rather than to try to find a cure for diseases after they occur.

Mon- Fri 7 a.m. – 3:30 p.m.

407-562-0974 phone

407-302-7323 fax

Kim.Norton2@hcahealthcare.com

Have a human resource (HR) question? – HCA - HRAnswers is available 24/7 by calling 844-472-6797

Central Florida Regional Hospital                                                                  

https://centralfloridaregional.com/

This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing, or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email or contact the sender at the number listed.

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

The information contained in this EMAIL message is confidential and protected by law. The information is intended only for the person or business identified in the document. If you are not the intended recipient, by sharing or copying the information you are breaking the law. If you have received this EMAIL by mistake, please notify the sender of this EMAIL and do not return, copy or keep the information in the EMAIL.