Marilyn Bulloch discusses the persistent burden of hepatitis B, evolving adult vaccination recommendations, and how pharmacists can improve vaccine uptake through accessible, stigma-free patient counseling.
In this episode of Pharmacy Focus, Marilyn Bulloch, PharmD, BCPS, FCCM, SPP, CPAFH, associate clinical professor at Auburn University’s Harrison College of Pharmacy, discusses the ongoing public health burden of hepatitis B and the growing importance of adult vaccination. Recorded during Hepatitis Awareness Month, the conversation highlights how hepatitis B remains widely misunderstood as primarily a childhood vaccination issue despite millions of adults remaining unvaccinated and at risk.
Bulloch explains that approximately 2.4 million individuals in the United States are living with chronic hepatitis B, many unknowingly due to the infection’s often asymptomatic nature. She emphasizes the strong clinical connection between chronic hepatitis B infection and liver cancer, noting that hepatitis B was effectively one of the first cancer-preventing vaccines developed. The discussion also addresses how historic risk factor–based vaccination recommendations contributed to stigma and left many patients unprotected.
The episode explores the Advisory Committee on Immunization Practices’ expanded recommendation for universal hepatitis B vaccination in adults through age 59, as well as the role pharmacists play in increasing vaccine awareness and accessibility. Bulloch highlights the importance of proactive but concise patient counseling, framing hepatitis B vaccination as cancer prevention rather than focusing solely on traditional risk factors.
The conversation also examines newer vaccination options, including the 2-dose hepatitis B vaccine series (HEPLISAV-B; Dynavax), which has improved completion rates compared with traditional 3-dose schedules. Bulloch notes that pharmacists are uniquely positioned to address vaccine hesitancy, misinformation, insurance barriers, and missed vaccination opportunities through routine patient interactions.
Throughout the episode, Bulloch underscores that hepatitis B can affect anyone, regardless of perceived risk factors, and encourages pharmacists to advocate for broader screening, universal vaccine access, and patient-centered education to help close persistent adult immunization gaps.
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