A review of the case for hepatitis B vaccination of high-risk adults.
The sequelae of hepatitis B virus infection include fulminant liver failure, chronic liver disease, hepatocellular carcinoma, and death. The hepatitis B vaccine is efficacious, safe, and cost-effective, but has been consistently underutilized in high-risk adults despite long-standing recommendations. Instituting routine hepatitis B vaccination for high-risk adults in settings such as prisons and jails, sexually transmitted disease clinics, drug treatment centers, and needle exchange programs could prevent up to 800 cases of hepatitis, and 10 deaths from hepatitis, per 10,000 vaccinations, with an overall cost savings. Low rates of completion of the three-dose series and lack of funding for adult immunizations have always been challenges to offering hepatitis B vaccines to high-risk adults. However, there is benefit to an incomplete vaccination series, and high-risk populations are accessible for follow-up vaccination outside of traditional medical settings. A clear national objective and federal funding for vaccinating high-risk adults are needed.
Rich
Josiah D
JD
The Miriam Hospital/Brown University School of Medicine, 164 Summit Avenue, Providence, RI 02906, USA. jrich@Lifespan.org
Ching
Catherine G
CG
Lally
Michelle A
MA
Gaitanis
Melissa M
MM
Schwartzapfel
Beth
B
Charuvastra
Anthony
A
Beckwith
Curt G
CG
Flanigan
Timothy P
TP
D000328:Adult; D002487:Centers for Disease Control and Prevention, U.S.; D005260:Female; D005500:Follow-Up Studies; D006509:Hepatitis B / Q000517:prevention & control*; D017325:Hepatitis B Vaccines / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011322:Primary Prevention / Q000592:standards / Q000639:trends; D018570:Risk Assessment; D012307:Risk Factors; D012309:Risk-Taking; D012680:Sensitivity and Specificity; D014481:United States; D014611:Vaccination / Q000592:standards* / Q000639:trends
D017325:Hepatitis B Vaccines