Back in February 1, 2025, we had an article on vaccinations titled, appropriately enough, “Vaccinations 2025”. It is now important to enlarge our knowledge about vaccinations because we live in an age where not everyone acknowledges the “settled science” that it represents. Most of us are aware that vaccines are designed to prevent infection. For example, the above referenced article focused on the deadly effects of polio if contracted (e.g., respiratory failure requiring up to a lifetime in an iron lung, weakness of limbs, etc.). All vaccines promote antibody formation before actual exposure to a virus, the polio vaccine included. However, certain vaccines not only prevent infection but also prevent cancer! For this article, we will discuss the earliest such immunomodulator, the hepatitis B vaccine.
First, let’s be candid and note that viral hepatitis, including hepatitis B, is not on the top 10 list of lethal diagnoses in the United States. Things like atherosclerosis, cancer, unintentional injuries, COPD, etc. cause significantly more mortality. However, the story behind hepatitis B vaccinations is unique and worth developing.
So what is hepatitis B and why is vaccination against it so critical? Viruses causing hepatitis (liver inflammation) are many. One subset of these viruses is explicitly named hepatitis A, B, C, etc.
Returning to our main focus, hepatitis B, approximately 14,000 new cases develop in the United States per year (as in the CDC article of 8/29/25-“Hepatitis B”). The vast majority of these occur in unvaccinated patients (the vaccine is very successful at preventing disease). Many patients are unaware that they have been infected because the initial symptoms are often mild. However, a meaningful number of these patients will not clear the virus and will become chronic carriers. In this disease, infants (age<1) are most likely to become chronic carriers (90%), then young children (ages 1-5:50%), and then older children and adults (5-10%) (as per the 2026 article “What Is Hepatitis B” by the Hepatitis B Foundation). If untreated, a large number of carriers will develop fibrosis (scarring) of the liver, fibrosis+regeneration of liver tissue (which defines cirrhosis), and liver cancer (please note that while cirrhosis is not necessary for liver cancer, liver cancer seems to develop more easily in those with cirrhosis).
So we discussed above acute cases. How many cases of chronic hepatitis B are diagnosed per year? The CDC, in another article called “Hepatitis B Surveillance” (4/15/25), says there were 17,650 new cases of chronic hepatitis B in 2023. Because this number exceeds the number of acute cases, one has to assume that there is a large pool of undiagnosed chronic hepatitis B carriers possibly within the newly immigrated populations. In the US alone, 2,400,000 citizens are currently chronic carriers (“Hepatitis B Facts and Figures”, Hepatitis B Foundation, 2026). Please note that chronic hepatitis B does have some treatment options these days.
There is disagreement amongst sources regarding hepatitis B mortality in the US but a reasonable approximation seems to be 2000/year. Thus, hepatitis B alone is not the most lethal entity that affects Americans but it is quite costly.
There is limited information also on the average cost per patient-year for treatment of chronic hepatitis B (as age of onset, residual liver function, presence of liver cancer, and liver transplantation all have major influences on cost) but absent definitive figures, this author would estimate an average of $25,000 per patient-year. Multiplying this by the number of chronic carriers yields the yearly figure of $60,000,000,000 per year to treat chronic hepatitis B. Of note, this does not count the loss to society of wages and other costs.
So, assuming universal hepatitis b vaccination with vaccine costs greatly reduced by the bulk, national purchases, the savings of that campaign would approach $60,000,000,000 per year (wages not lost because of illness are a bonus). This is just for preventing 1 virus. Of note, HPV (human papilloma virus) also has a successful vaccine which prevents multiple cancers.
So, in summary, hepatitis B vaccines quite successfully prevent acute infection leading to chronic infection leading to liver failure, cirrhosis, and liver cancer (all of which are very expensive medical conditions to treat). With just this 1 vaccine, amazing benefits can be realized. Overall, vaccines remain 1 of the most cost-effective weapons of the medical system. The side effects are low and the benefits are high.
All in all, the world owes a great debt of thanks to the English physician Edward Jenner, the first “vaccinator”, who discovered how to prevent smallpox. He was onto something very big.