Two-Dose HBV Vaccine Offers Protection and Cost Savings for Hospital Systems

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When comparing a 3-dose hepatitis B virus (HBV) vaccine with a 2-dose version for healthcare professionals, the lower-dose version could result in significant cost savings while maintaining protection. hospital systems.

A team, led by Catherine Stevenson, Market Access and Policy, Dynavax Technologies, identified the health and economic impact of implementing a 2-dose HBV vaccination strategy in health facilities compared to a 3-dose HBV vaccine.

Compare vaccines

In recent years, many healthcare establishments have implemented preventive vaccination programs to reduce exposure to HBV in patients and healthcare professionals. However, there is a percentage of unprotected healthcare workers, especially those entering a healthcare system for the first time and those undergoing vocational training.

First generation HBV vaccinations require the administration of 3 doses of vaccine over a 6 month period for maximum immunogenicity.

On the other hand, HepB-CpG is a 2-dose vaccine in use in the United States since 2017, which includes rapid seroprotection over a one-month interval.

While the 2-dose version offers more immediate protection against HBV, the 3-dose vaccine has been shown to induce earlier and significantly higher rates of seroprotection in healthy adults aged 18 to 70 years.

“Thus, HepB-CpG may represent a powerful tool for healthcare systems by providing rapid protection against HBV for healthcare professionals, especially among those who have just entered the system and at high risk of infection. “, wrote the authors.

Test it in a hospital

Investigators targeted 1,910 health professionals newly entered into a health system over a period of one year. They used a model that exploits seroprotection rates, which takes into account the vaccine compliance of healthcare professionals and seroprotection rates for different dosing regimens. The team also looked at current prices for post-exposure prophylaxis.

Each unprotected healthcare worker was vaccinated with either vaccine at month 0 and the investigators estimated a monthly risk of HBV exposure of 3% based on available data.

The researchers investigated the main outcomes of the number of healthcare professionals protected against HBV, the number of healthcare professionals potentially exposed to HBV and the cost of post-exposure prophylaxis among healthcare professionals requiring intervention. .

Results

After the completion of the 2-dose vaccine, 1,725 ​​newly recruited healthcare professionals were protected against HBV, which represents a 77% increase in protection over the second dose of the 3-dose schedule. The HepB-CpG vaccine would also protect an additional 24% of newly recruited healthcare professionals at the end of the series compared to the 3-dose vaccine.

If a hospital system used the 3-dose vaccine, 173 unprotected healthcare workers would potentially be exposed to HBV and require intervention within 1-6 months of entry, and 249 would be exposed to HBV for the entire one-year period. .

However, if they used the 2-dose vaccine, the estimated reduction in the first 1-6 months would be 51%, with about 84 unprotected people exposed to HBV within 1-6 months and 115 exposed throughout. the 1 year study. .

There was an overall reduction in risk for unprotected healthcare professionals of 54% if the 2-dose vaccine is used compared to the 3-dose version.

“Compared to the 3-dose vaccine, HepB-CpG was expected to provide faster and increased protection against HBV infection in newly hired healthcare professionals,” the authors wrote. “By protecting a greater percentage of HCP, HepB-CpG was also expected to significantly reduce the risk of exposure to HBV.”

In addition, economic data shows that HepB-CpG would ultimately reduce the costs of post-exposure prophylaxis compared to the 3-dose vaccine. For the one-year study period, the hospital system that implements the 3-dose vaccine would spend about $ 100,000 on prophylaxis, compared to $ 63,000 for the hospital that uses HepB-CpG.

There are approximately 248 million patients with chronic HBV worldwide, of which 840,000 live in the United States.

The study, “Preventing hepatitis B virus infection in healthcare professionals: potential impact of a 2-dose versus 3-dose vaccine,” was published online in Human vaccines and immunotherapy.

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