HepB-CpG Series for Healthcare Workers Who Are Hepatitis B Vaccine Nonresponders

Study Overview
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Brief Summary
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This study is being done to determine if healthcare workers who have previously failed to respond to hepatitis B vaccine series will respond to a hepatitis B with CpG adjuvant (hepB-CpG) (Heplisav-B)

Detailed Description
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Study Intervention Each individual who has completed at least 5 doses hepB vaccine with aluminum adjuvant series but is anti-HBs negative will be contacted by EHS staff and invited to receive the hepB-CpG two dose series on a 0 and 1 month schedule. Antibody to the surface antigen will be measured after the first dose during the visit for the administration of the second dose. One month after completion of the series, each immunized individual will have another anti-HBs measured. Total Number of Subjects Up to 130 individuals will be recruited and enrolled. Study Population Healthcare workers who have received at least 5 doses of hepatitis B vaccine with aluminum adjuvant and have antiHBs < 10mIU/ml.

Official Title
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HepB-CpG Series for Healthcare Workers Who Are Hepatitis B Vaccine Nonresponders

Conditions
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Healthcare Worker, Hepatitis B Vaccine, Nonresponder

Intervention / Treatment
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* Biological: Recombinant hepatitis B vaccine with CpG adjuvant


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Willing to provide informed consent Willing to comply with all study procedures and be available for the duration of the study Healthcare workers who have received at least 5 doses of hepatitis B vaccine with aluminum adjuvant and have antiHBs < 10mIU/ml Females of childbearing potential will be asked about the possibility of pregnancy as is the standard of care for immunization services. If a female indicates that she may be pregnant, study participation will be postponed until pregnancy is completed or the female reports that she is not pregnant. Exclusion Criteria: Women who are pregnant or planning on becoming pregnant during the study Allergy to the vaccine or a component of the vaccine Not suitable for study participation due to other reasons, such as inability or unwillingness to comply with the study procedures, at the discretion of the investigators

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Healthcare worker<br>Healthcare worker who has previously received at least 5 doses of hepatitis B vaccine with aluminum adjuvant (Recombivax B or Engerix B) and has an antibody to the hepatitis B surface antigen (antiHBs) that is less than 10 mIU/ml. | Biological: Recombinant hepatitis B vaccine with CpG adjuvant<br>* Each participant will receive two doses of hepB-CpG separated by one month and blood draw to measure antibody to the hepatitis B surface antigen prior to dose 2 and one month after dose 2.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of participants who failed to respond to 5 or more doses of hepatitis B vaccine with aluminum adjuvant who respond to hepatitis B vaccine with CpG adjuvant series | Response is defined as AntiHBs >10 mIU/ml following two doses of hepB-CpG | one month after dose 2 (up to 84 days on study) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of participants who respond to a single dose of hepB-CpG | Response is defined as AntiHBs >10 mIU/ml following a single dose of hepB-CpG | one month after dose 1 (up to 42 days on study) | 
| Proportion of participants who are nonresponders with each risk factor | A multivariate model will be developed by measuring the proportion of participants who are nonresponders with each risk factor. Potential risk factors include including age, smoking status, sex, diabetes, immunosuppression. | one month after dose 2 (up to 84 days on study) |