A prospective cohort noninferiority study stated that there was no increase in the risk of a heart attack among patients who received two-dose hepatitis B cytosine phosphoguanine adjuvant vaccine (Heplisav-B) compared to the three-dose hepatitis B vaccine with an aluminum hydroxide adjuvant (Engerix-B).

A total of 69 625 adults not undergoing dialysis were divided into two groups, one receiving an index dose of the two-dose vaccine (n=31,183) and the other receiving a three-dose vaccine (n=38,442). It was observed that 52  type 1 acute MI events occurred among recipients of HepB-CpG vaccine for a rate of 1.67 per 1000-person-years, and 71 type 1 acute MI events occurred in recipients of HepB-alum vaccine (1.86 per 1000 person-years) (absolute rate difference, −0.19 [95% CI, −0.82 to 0.44]. Adjusted hazard ratio (HR) was 0.92 [1-sided 97.5% CI, ∞ to 1.32], which was below the noninferiority margin; P < .001 for noninferiority). The study was published in JAMA. (MedPage Today March 28, 2022; JAMA, published online March 25, 2022. doi:10.1001/jama.2022.2540)