Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Expanding hepatitis B vaccine recommendations for adults

William Schaffner, MD
Physician
November 7, 2010
Share
Tweet
Share

My colleagues at the Advisory Committee on Immunization Practices (ACIP) are examining a proposed policy for hepatitis B vaccination for diabetic patients. If accepted, this would be the next in a series of baby steps expanding hepatitis B vaccine recommendations for adults. While we are taking these baby steps, HBV incidence rates among U.S. adults remain pretty flat, and they haven’t changed much since 2006.

We know the vaccine works. We can tell because one of our previous baby steps (the one actually involving babies) was universal vaccination of infants and screening of pregnant women put in place in 1991. That was followed by the recommendation for the universal immunization of all children and adolescents. Since then, hepatitis B rates in these age groups have plummeted. That’s not surprising. Comprehensive vaccination leads to these kinds of results while targeted vaccination can lead to, well, not much.

In the case of HBV, we are dropping the ball for adults. Just as young adults enter the period of life when the risk of exposure increases, they enter the period when the vaccine is no longer recommended universally. Indeed, you first have to incur some risk before you are eligible for vaccination. Hmmm … I thought the concept of prevention was to provide vaccine before the individual was exposed.

This paradox becomes even more evident when you consider that, according to ACIP, since 1991 we have had a strategy aimed at the elimination of HBV transmission here in the United States. Some strategy: we wait for the immunized children and adolescents to grow up. That’s not a strategy, that’s lethargy.

Targeted HBV immunization program for adults has stalled. This may have more long-term health implications than we realize. We already know that 30% of all liver cancers in the United States are caused by HBV. Now there is a new study from investigators at the NIH and in South Korea showing that individuals with HBV are twice as likely to develop non-Hodgkin’s lymphoma.

We already know more than enough about the benefits and safety of HBV vaccination to advocate for a broad recommendation for the immunization of adults. Indeed, HBV vaccine already is recommended for “sexually active persons who are not in a long-term, mutually monogamous relationship”. Not very well known, this already verges on a universal recommendation for unmarried young adults (and many older adults).

Enough with the baby steps — let’s take a substantial adult leap and extend the recommendation for universal HBV vaccination beyond the 19th birthday into adulthood. That would be a real strategy to eliminate transmission of this virus in the United States.

William Schaffner is Professor and Chair, Department of Preventive Medicine, Vanderbilt University School of Medicine, and blogs at Infectious Disease News.

Submit a guest post and be heard.

Prev

Why total body scans are a scam

November 7, 2010 Kevin 9
…
Next

Questions about the early diagnosis of Alzheimer’s disease

November 8, 2010 Kevin 6
…

Tagged as: Patients, Primary Care

Post navigation

< Previous Post
Why total body scans are a scam
Next Post >
Questions about the early diagnosis of Alzheimer’s disease

ADVERTISEMENT

More by William Schaffner, MD

  • Make a difference by being a vaccine insister

    William Schaffner, MD
  • a desk with keyboard and ipad with the kevinmd logo

    Ways to improve influenza immunization rates

    William Schaffner, MD
  • a desk with keyboard and ipad with the kevinmd logo

    Can vaccine recommendations be based solely on individual and public health?

    William Schaffner, MD

More in Physician

  • Why the heart of medicine is more than science

    Ryan Nadelson, MD
  • How Ukrainian doctors kept diabetes care alive during the war

    Dr. Daryna Bahriy
  • How women physicians can go from burnout to thriving

    Diane W. Shannon, MD, MPH
  • Why more doctors are choosing direct care over traditional health care

    Grace Torres-Hodges, DPM, MBA
  • How to handle chronically late patients in your medical practice

    Neil Baum, MD
  • How early meetings and after-hours events penalize physician-mothers

    Samira Jeimy, MD, PhD and Menaka Pai, MD
  • Most Popular

  • Past Week

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • America’s ER crisis: Why the system is collapsing from within

      Kristen Cline, BSN, RN | Conditions
    • Why timing, not surgery, determines patient survival

      Michael Karch, MD | Conditions
    • How early meetings and after-hours events penalize physician-mothers

      Samira Jeimy, MD, PhD and Menaka Pai, MD | Physician
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
  • Recent Posts

    • Why the heart of medicine is more than science

      Ryan Nadelson, MD | Physician
    • How Ukrainian doctors kept diabetes care alive during the war

      Dr. Daryna Bahriy | Physician
    • Why Grok 4 could be the next leap for HIPAA-compliant clinical AI

      Harvey Castro, MD, MBA | Tech
    • How women physicians can go from burnout to thriving

      Diane W. Shannon, MD, MPH | Physician
    • What a childhood stroke taught me about the future of neurosurgery and the promise of vagus nerve stimulation

      William J. Bannon IV | Conditions
    • Beyond burnout: Understanding the triangle of exhaustion [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • America’s ER crisis: Why the system is collapsing from within

      Kristen Cline, BSN, RN | Conditions
    • Why timing, not surgery, determines patient survival

      Michael Karch, MD | Conditions
    • How early meetings and after-hours events penalize physician-mothers

      Samira Jeimy, MD, PhD and Menaka Pai, MD | Physician
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
  • Recent Posts

    • Why the heart of medicine is more than science

      Ryan Nadelson, MD | Physician
    • How Ukrainian doctors kept diabetes care alive during the war

      Dr. Daryna Bahriy | Physician
    • Why Grok 4 could be the next leap for HIPAA-compliant clinical AI

      Harvey Castro, MD, MBA | Tech
    • How women physicians can go from burnout to thriving

      Diane W. Shannon, MD, MPH | Physician
    • What a childhood stroke taught me about the future of neurosurgery and the promise of vagus nerve stimulation

      William J. Bannon IV | Conditions
    • Beyond burnout: Understanding the triangle of exhaustion [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...