What Medicare Beneficiaries Need to Know About Hepatitis B Vaccines
As of January 2023, all Medicare-covered vaccines are available for free to Medicare beneficiaries. This means beneficiaries are not responsible for any cost-sharing, such as copayment, coinsurance, or deductibles for covered vaccines.
One vaccine covered under the Medicare rule is the hepatitis B vaccine. Hepatitis B is a vaccine-preventable liver infection caused by the hepatitis B virus. It is spread when blood, semen, or other body fluids from a person infected with the virus enters the body of someone who is not infected. The CDC recommends that adults aged 60 or older with risk factors for hepatitis B should receive a hepatitis B vaccination.
To help Medicare beneficiaries better understand the importance of hepatitis B vaccination, Real World Health Care reached out to Michaela Jackson, MPH MS, Program Director, Prevention Policy, Hepatitis B Foundation for insights.
Hepatitis B: Who is At Risk?
Real World Health Care: Who is most at risk for hepatitis B, and how can having the disease impact their lives?
Michaela Jackson
Michaela Jackson: Hepatitis B is a global threat to public health with significant impacts on a person’s life. There are nearly 300 million people living with chronic hepatitis B worldwide, and up to 2.4 million of those individuals live in the United States. Although there is no cure, there are highly effective treatments.
All adults are at some degree of risk for hepatitis B because of how easily it can be transmitted and its lack of identifiable symptoms. However, certain groups are at an increased risk of hepatitis B infection. Here in the U.S., hepatitis B disproportionately impacts Asian Americans, Pacific Islanders, and African Immigrant communities. We have also seen an increase in hepatitis B cases in states heavily impacted by the opioid epidemic. Certain occupations, such as health care workers and emergency responders, and people with certain health conditions, such as diabetes or dialysis patients, are also at a higher risk of contracting hepatitis B.
People living with hepatitis B face an increased risk of developing serious liver complications, such as cirrhosis, liver failure, or even liver cancer. If left untreated, one in four individuals will die prematurely from hepatitis B-related liver complications.
Hepatitis B Myths vs. Facts
RWHC: What are some of the biggest misconceptions people have about hepatitis B?
MJ: Two of the biggest misconceptions about hepatitis B are that it can be spread through casual contact and that hepatitis B only infects certain individuals. As a blood-borne disease, hepatitis B is spread through direct contact with infected blood. It cannot be transmitted through hugging, holding hands, or sharing meals with someone who is living with hepatitis B. The virus is also not airborne, so it cannot be spread through sneezing or coughing. Oftentimes, people living with hepatitis B face stigma and isolation because of this misconception, so it is very important to address this!
It is also a common misconception that hepatitis B only impacts people who participate in certain behaviors, such as injecting drugs or getting tattoos. This is a stigmatizing viewpoint that misleads individuals into thinking that they don’t need to get tested or vaccinated for hepatitis B, and thus leaves individuals vulnerable to new infections. The truth is that nearly 40 percent of new acute hepatitis B cases have no risk factor information. Additionally, more than 60 percent of people living with hepatitis B are unaware of their infection. Although certain groups have a higher chance of contracting the virus, hepatitis B can impact anyone – regardless of obvious risk factors.
Hepatitis B Vaccines: Essential for Disease Prevention
RWHC: Why are vaccines such an important part of the prevention equation for hepatitis B?
MJ: Vaccines are essential to preventing hepatitis B for so many reasons! To start, preventing hepatitis B means preventing primary liver cancer. Hepatitis B is the world’s leading cause of liver disease and liver cancer, with over 60 percent of global liver cancer cases attributed to the virus. A person living with chronic hepatitis B has a 25-40 percent lifetime risk of developing liver cancer if left unmanaged. By getting vaccinated against hepatitis B, you are significantly reducing this risk. The vaccine also prevents hepatitis delta – the most severe form of viral hepatitis that can only occur in people who are already living with hepatitis B. Hepatitis delta carries a liver cancer risk of up to 70 percent.
Hepatitis B can also be spread from mother to child during the birthing process – this is the most common way hepatitis B is transmitted globally. And – nine out of ten babies who are born with hepatitis B will develop a chronic infection. Vaccination not only protects you, but also your family and your loved ones.
The Hepatitis B Vaccine is Safe and Effective
RWHC: What should people know about getting vaccinated for hepatitis B?
MJ: The hepatitis B vaccine is safe, effective, and free under most health insurance plans. Most adults are shocked to learn that they are not vaccinated against hepatitis B. Universal infant vaccination was only recommended beginning in 1991, so most people born before 1991 never received their hepatitis B vaccination. If you are unsure about your vaccination status, the best thing to do is check your immunization records and speak with your doctor.
People should also know that the hepatitis B vaccine provides a lifetime of protection against the hepatitis B virus – no boosters necessary after you complete the series! Getting vaccinated is a quick and simple way to prevent serious consequences.
Inflation Reduction Act Coverage for Hepatitis B Vaccines
RWHC: How has the Inflation Reduction Act, which includes provisions for Medicare to cover vaccines at no cost for beneficiaries, helped to increase uptake for hepatitis B vaccines?
MJ: For a two- or three-dose vaccine, paying out-of-pocket per dose adds up quickly. Prior to the Inflation Reduction Act (IRA), we often received calls from individuals on Medicare who wanted to get vaccinated, were considered at-risk for infection, and simply could not afford to pay for it.
We are hopeful that the IRA, coupled with updated adult hepatitis B vaccination recommendations from the CDC, will help increase hepatitis B vaccinations amongst people who are on Medicare. As a now-routine immunization, hepatitis B vaccination is gaining more awareness than before. Data shows hepatitis B outbreaks still occur in long-term care facilities, and we also continue to see slight national upticks occur amongst people aged 60 and older. There is a clear need for hepatitis B vaccination amongst the Medicare population, and now they have one less barrier to accessing the vaccine.
Hepatitis B Foundation Takes a Comprehensive Approach to Vaccinations
RWHC: How is the Hepatitis B Foundation working to raise awareness for the importance of getting vaccinated and driving vaccination rates?
MJ: Increasing vaccination rates involves many different stakeholders, which makes it critical to take a comprehensive approach to this endeavor. Each year, we educate policymakers and communities on the importance of hepatitis B vaccination during key awareness days and months, such as National Adult Hepatitis B Vaccination Awareness Day (April 30th), Hepatitis Awareness Month (May) and Immunization Awareness Month (August).
The Foundation also works closely with providers to identify systemic barriers to increasing hepatitis B vaccination, and to create resources, like this vaccine handout, that aid their current hepatitis B vaccination efforts.
In addition to working with providers, we collaborate with people who are living with or have been impacted by hepatitis B. Our national storytelling campaign, #justB, highlights the powerful experiences of those affected by hepatitis B to raise awareness and encourage people to get tested and vaccinated. Stories like Sura’s, whose brother passed away from a fulminant hepatitis B infection, and DeWayne’s, who was diagnosed with hepatitis B after he had a blood transfusion as a child, speak to the importance of vaccination.
Our national coalition, Hep B United, is integral to our efforts. With almost 60 organizations across 27 states in the U.S., the coalition is a powerful partner in spreading education about hepatitis B and encouraging people to get screened and vaccinated. The coalition includes many community-based organizations and federally qualified health centers that actively immunize individuals as well as raising awareness. It truly is a team effort to increase vaccination rates!