2 dose Hepatitis B vaccine not significantly associated with increased MI risk compared to 3 dose vaccine: JAMA

When comparing the hepatitis B vaccination with a cytosine phosphoguanine adjuvant (HepB-CpG) vaccination to the HepB-alum vaccine, the statistical threshold for a higher risk of acute myocardial infarction was not met, says an article published in the Journal of American Medical Association.

In prelicensure trials, a 2-dose HepB-CpG vaccine (Heplisav-B) produced greater seroprotection than a 3-dose hepatitis B vaccine with an aluminium hydroxide adjuvant (HepB-alum vaccine; Engerix-B). However, in one trial, those who received the HepB-CpG vaccine had a higher rate of acute myocardial infarction (MI) than those who received the HepB-alum vaccine, a finding that warrants additional investigation. Katia Bruxvoort and colleagues undertook this study to examine the rate of acute MI in recipients of the HepB-CpG and HepB-alum vaccines.

Kaiser Permanente Southern California (KPSC), an integrated health care system with 15 medical sites and nearly 4.7 million members, undertook this prospective cohort noninferiority trial. From August 7, 2018, to October 31, 2019, 69 625 people who were not on dialysis received at least one dose of hepatitis B vaccine in either the family medicine or internal medicine departments at KPSC (November 30, 2020, final follow-up). Receipt of HepB-CpG vaccine vs. HepB-alum vaccine were given to the subjects. The index dose was given initially during the trial period.