Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Completion of Hepatitis Vaccination Low in US

Vaccine; ePub 2018 Jun 19; Trantham, et al

Among US adults, adherence with and completion of recommended hepatitis multidose vaccine schedules are low, with the majority of adults initiating vaccination potentially missing the full protective benefit of all doses. This according to a retrospective database study of administrative claims from 2008 to 2015. Completion of 2 (Hep A) and 3 doses (HepB and HepA-HepB), and adherence to the 2- and 3-dose recommended schedules were measured among individuals aged ≥19 years at first dose. Researchers found:

  • Only 27% of adults initiating HepA vaccine were adherent to the 2-dose schedule.
  • Approximately one-third of adults who initiated the HepB or HepA-HepB series completed all 3 doses in 2 years.
  • Most HepA or HepB vaccine initiators miss the full protective benefit of all doses.


Trantham L, Kurosky SK, Zhang D, Johnson KD. Adherence with and completion of recommended hepatitis vaccination schedules among adults in the United States. [Published online ahead of print June 19, 2018]. Vaccine. doi:10.1016/j.vaccine.2018.05.111.


The administration of the Hepatitis-B vaccination is truly a success story. Since the year 2000, the annual number of acute hepatitis-B cases in the US has decreased from 8,000 to less than 4,000. With increased injection drug use in the US, there has been an increase since 2014. The ACIP reported this year that less than 30% of adults overall in the US have received 3 doses of hepatitis-B vaccine. That includes only 30% of patients with chronic liver disease; less than 30% of our diabetic patients; and only 60% of our health care personnel. In February of 2018, the ACIP recommended a new hepatitis-B vaccination for use in the US. One of the advantages of this vaccination is that protection is achieved through only 2 doses 1 month apart. Perhaps this simpler regimen will increase the overall protection against hepatitis-B in this country. —John Russell, MD