Hepatitis B Is Still Active: What Pharmacists Need to Know About Adult Transmission Rates and Vaccine Gaps

In an interview with Pharmacy Times, Spencer Durham, PharmD, FCCP, BCPS, BCIDP, associate clinical professor of pharmacy practice and director of professional affairs at Auburn University Harrison College of Pharmacy, addressed the continued urgency of hepatitis B vaccination in adults and the evolving role pharmacists play in closing immunization gaps during Hepatitis Awareness Month.

Durham challenged the perception that hepatitis B represents a resolved public health threat. While confirmed acute cases numbered approximately 2200 in 2023 according to CDC data, he emphasized that the true burden is far greater—estimated at roughly 14,000 new infections annually when accounting for cases that go undiagnosed or unreported. Notably, adults aged 40 to 59 now carry the highest rates of newly reported infections, a demographic that pharmacists are well positioned to reach through routine immunization services and medication counseling encounters.

Beyond framing hepatitis B as an infectious disease concern, Durham underscored its direct link to primary liver cancer, arguing that pharmacists should reposition the vaccine in patient conversations as a cancer prevention tool. He drew a parallel to HPV vaccination, noting that framing hepatitis B immunization in terms of cancer risk reduction—rather than infection avoidance—is likely to resonate more powerfully with adult patients who feel otherwise healthy and asymptomatic.

Durham also addressed the clinical and public health implications of the 2-dose recombinant hepatitis B vaccine, adjuvanted (Heplisav-B, Dynavax Technologies) regimen, compared with the traditional 3-dose series administered over 6 months. He noted that the compressed timeline not only improves series completion rates—a longstanding challenge with the conventional schedule—but also confers earlier and more robust seroprotection. For pharmacists advising patients on vaccine selection, Durham emphasized that faster immunity translates to reduced transmission risk and a meaningfully lower likelihood of patients developing hepatic cancer over time.