Protecting Against Hepatitis B in 21 Days

A new study suggests an accelerated hepatitis B vaccine schedule could benefit vulnerable populations

February 14, 2025

Coauthored by Giten Khwairakpam, program manager, community and policy, for amfAR’s TREAT Asia program, a recently published study shows that an accelerated vaccine regimen to prevent hepatitis B (HBV) infection can be an effective option for people who inject drugs (PWID) and others who have not yet been vaccinated. The rapid regimen reduces a six-month process to 21 days.

Along with syringe exchange programs, a rapid HBV vaccine regimen is a much-needed option for PWID, who are at high risk for acquiring the virus. If untreated, chronic HBV can lead to cirrhosis and liver cancer, among other negative health outcomes. The Asia-Pacific region is especially hard hit by HBV, comprising 62% of the estimated 254 million people living with chronic HBV globally and 67% of HBV-related deaths.

The standard HBV vaccine regimen—three doses delivered over six months—is highly effective, protecting 90–95% of those who are immunized from acquiring the virus. However, adherence to the full dosing schedule is particularly low among PWID.

“The wait time between injections and the need to return three times over a six-month period to complete the course are the main reasons why people find the standard regimen challenging,” says Giten Khwairakpam.

Led by TREAT Asia partner Community Network for Empowerment (CoNE) in Manipur, India, the study included 567 male PWID in Manipur, India, who received either the standard HBV regimen or the accelerated schedule.

The rapid regimen led to high levels of antibody protection, though not at the level of those who received the standard regimen. The authors suggest that the rapid regimen may be an alternative to the standard schedule for high-risk groups who need quick protection.

Though the rapid regimen has been recommended for adults by the World Health Organization since 2012, it has not been widely implemented.

Khwairakpam believes uptake can be increased.

“Wider implementation of the rapid regimen in part depends on increasing awareness about the option, integrating HBV vaccination at clinics and programs providing harm reduction services, and providing PWID with the option of a rapid or standard regimen.”