{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T03:14:13Z","timestamp":1788146053021,"version":"build-2803163510"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2021,12,19]],"date-time":"2021-12-19T00:00:00Z","timestamp":1639872000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2021,12,19]],"date-time":"2021-12-19T00:00:00Z","timestamp":1639872000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatology"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background and Aims<\/jats:title>\n            <jats:p>Hepatitis B vaccine has been included in the infant immunization schedule since 1991 in the United States. We aimed to assess its effectiveness against HBV infection and its impact on mortality.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Approach and Results<\/jats:title>\n            <jats:p>The study population was participants aged 6+ years with an HBV vaccination history and an HBV serologic test from the National Health and Nutrition Examination Survey, 1999\u20132018. Participants aged 18+ years with linked mortality records from 1999\u20132014 were followed for mortality analysis. Multivariable logistic regression was used to compute vaccine effectiveness (VE) overall, by year of birth, and by age. Cox regression was used to estimate HRs for all\u2010cause, cancer\u2010related, and cardiovascular disease\u2013related mortality. A total of 64,107 participants were included in the main analysis, with 29,600 (40.7%) having completed HBV vaccination (three or more doses, vaccinated). The highest vaccination uptake was found among those born after 1991, at 86.5%. Vaccinated participants had higher prevalence of vaccine\u2010induced immunity than the unvaccinated (47.2% vs. 7.4%). Among those born after 1991, VE was found at 58% (95% CI, 18%\u201379%) overall and 85% for those aged \u226520\u00a0years (mean age, 22), whereas no effect was found among those born prior to 1990. HBV vaccination was associated with reduced risk of all\u2010cause mortality (HR, 0.78; 95% CI, 0.68\u20130.90) and cancer\u2010related mortality (HR, 0.76; 95% CI, 0.58\u20131.00) but not for cardiovascular disease\u2013related mortality.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>In the universal infant vaccination era, the HBV vaccine has shown substantial effectiveness against HBV infection and maintained strong protection for 20\u00a0years. It was also associated with reduced risk of all\u2010cause and cancer\u2010related mortality.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/hep.32265","type":"journal-article","created":{"date-parts":[[2021,12,2]],"date-time":"2021-12-02T14:51:05Z","timestamp":1638456665000},"page":"1566-1578","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":23,"title":["The impact of hepatitis B vaccination in the United States, 1999\u20132018"],"prefix":"10.1097","volume":"75","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7475-8485","authenticated-orcid":false,"given":"Wen\u2010Qiang","family":"He","sequence":"first","affiliation":[{"name":"School of Population Health,University of New South Wales Sydney,Sydney,Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guan Nan","family":"Guo","sequence":"additional","affiliation":[{"name":"School of Population Health,University of New South Wales Sydney,Sydney,Australia"},{"name":"National Research and Data,Cancer Australia,Sydney,Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenxi","family":"Li","sequence":"additional","affiliation":[{"name":"School of Population Health,University of New South Wales Sydney,Sydney,Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,12,19]]},"reference":[{"key":"hep32265-bib-0001-20250824","doi-asserted-by":"crossref","first-page":"1749","DOI":"10.1001\/jamaoncol.2019.2996","article-title":"Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability\u2010adjusted life\u2010years for 29 cancer groups, 1990 to 2017: a systematic analysis for the Global Burden of Disease Study","volume":"5","year":"2019","journal-title":"JAMA Oncol"},{"key":"hep32265-bib-0002-20250824","doi-asserted-by":"crossref","first-page":"2353","DOI":"10.1002\/hep.31991","article-title":"Prevalence of HBV infection, vaccine\u2010induced immunity, and susceptibility among at\u2010risk populations: US households, 2013\u20132018","volume":"74","year":"2021","journal-title":"Hepatology"},{"key":"hep32265-bib-0003-20250824","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1093\/cid\/ciz001","article-title":"Prevalence of hepatitis B and hepatitis D virus infections in the United States, 2011\u20132016","volume":"69","year":"2019","journal-title":"Clin Infect Dis"},{"key":"hep32265-bib-0005-20250824","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1016\/j.vaccine.2017.01.020","article-title":"Impact of universal infant hepatitis B vaccination in the US\u2010affiliated Pacific Islands, 1985\u20132015","volume":"35","year":"2017","journal-title":"Vaccine"},{"key":"hep32265-bib-0006-20250824","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1111\/jvh.13202","article-title":"Trends in chronic hepatitis B prevalence in Australian women by country of birth, 2000 to 2016","volume":"27","year":"2020","journal-title":"J Viral Hepat"},{"key":"hep32265-bib-0007-20250824","doi-asserted-by":"crossref","first-page":"2721","DOI":"10.1016\/j.vaccine.2017.11.004","article-title":"Hepatitis B infection control in Colombian Amazon after 15 years of hepatitis B vaccination. 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