CDC, ACIP Updates to Hepatitis B Vaccination Eligibility in 2022

The Advisory Committee on Immunization Practices and CDC have prioritized making HBV vaccination recommendations simpler to ease the vaccination process for immunizers and to decrease barriers.

The hepatitis B virus (HBV) vaccine became a universal recommendation for vaccination in children back in 1991, said Amanda Price, PharmD, BCACP, in a presentation at the American Society of Health-System Pharmacists 2022 Summer Meeting. Because of this, Price explained that the population requiring this vaccination will gradually age out of that requirement, making the disease and the vaccine a thing of the past over time.

“As the children who received it become older and older, this will become less of a consideration,” Price said. “But right now, we still have many patients who need to be offered the [HBV] series.”

For this reason, the Advisory Committee on Immunization Practices (ACIP) and CDC prioritized making the vaccination recommendation simpler to ease the vaccination process for immunizers and to decrease barriers to access. In 2021, the ACIP and CDC had required clinicians to conduct multiple risk-based assessments to determine whether a patient qualified for an HBV vaccination. After reviewing the HBV vaccination data, the results showed that this was not an effective strategy, according to Price.

“They recognized that with this scenario, we as clinicians were doing a poor job. Documentation suggests that in the year 2018, only about 30% of patients with chronic liver disease, 30% of patients with diabetes, and, embarrassingly, only about 63% of health care providers had completed a full series of the hep B vaccination,” Price said. “Clearly, there were some barriers to accomplishing this task, even though we know it prevents a potentially problematic bloodborne illness.”

When these low vaccination rates were identified, the CDC and ACIP asked clinicians what they thought might be the barriers to higher rates of HBV immunization. The clinicians explained that in their experience, the invasive and personal risk-based questions required to determine patients’ eligibility were a significant barrier.

In acknowledgement of these barriers, the CDC and ACIP decided to remove these risk-based assessments entirely and make the HBV vaccination series a universal recommendation. Now, all individuals between 18 and 59 years of age are eligible and should get this vaccination series.

However, the CDC and ACIP did not make this universal recommendation for the HBV vaccine series in adults older than 60 years of age, because this population has a lower risk of HBV. Instead, the CDC and ACIP recommend patients who are older than 60 years of age be vaccinated if they are at risk by sexual exposure, exposure to blood, and/or travel, as well as if they have chronic liver disease, HIV, and/or hepatitis C virus or are incarcerated. Additionally, individuals in this population who would like to be protected from HBV are eligible as well.

REFERENCE

Price A. Vaccination Updates 2022: COVID-19 and Beyond. Presented at: ASHP Summer Meeting 2022; June 12, 2022; Phoenix, AZ.