National Progress Report 2020 Goal: Reduce the rate of reported acute hepatitis B virus (HBV) infections among persons aged ≥19 years to 0.50 per 100,000 population

Incidence rate* of reported HBV infections among persons aged ≥19 years

Bar chart for years 2010-2020, charting rate per 100,000, 1.44 for 2010, 1.21 for 2011, 1.20 for 2012, 1.26 for 2013, 1.16 for 2014, 1.38 for 2015, 1.31 for 2016 and projected downward to .5 by 2020.

Source: CDC, National Notifiable Diseases Surveillance System (data run, May 25, 2018)
*Rate per 100,000 U.S. population

Summary of Findings

The rate of reported acute HBV infections among persons aged ≥19 years decreased from 1.38 per 100,000 U.S. population in 2015 to 1.31 per 100,000 in 2016; however, the 2016 target of 0.94 cases per 100,000 U.S. population was not met.

Reduction needed to meet 2020 goal: A 61.8% reduction from the 2016 reported acute HBV infection rate is needed to meet the 2020 goal of 0.50 cases per 100,000 U.S. population.

This reduction can best be achieved by

  • Promoting implementation of vaccine recommendations through provider education, strategic partnerships, and other measures.
  • Building capacity for states to collect and use a core set of surveillance data to detect at-risk populations and gaps in vaccination coverage.
  • Conducting prevention research to demonstrate how best to provide hepatitis B vaccination, testing, and treatment as part of a comprehensive set of interventions for persons who inject drugs.
  • Encouraging unvaccinated persons to use HHS’s Adult Vaccine FinderExternal to locate providers of recommended adult vaccines and get immunized against hepatitis B.

Technical Notes

Data Sources: CDC, National Notifiable Diseases Surveillance System (NNDSS) and CDC/NCHS/U.S. Census Bureau, Bridged-race Population Estimates

Numerator: Number of acute HBV infections reported among persons aged ≥19 years annually

Denominator: Total population of persons aged ≥19 years in reporting states

Indicator Notes: The NNDSS is a nationwide collaboration that enables all levels of public health to share notifiable-disease-related health information. Surveillance for viral hepatitis through NNDSS is based on case definitions developed and approved by the Council of State and Territorial Epidemiologists (CSTE) and CDC. Reported cases of acute viral hepatitis B are required to meet specific clinical and laboratory criteria. Only laboratory-confirmed cases of acute viral hepatitis are presented in this report. Acute hepatitis B is reportable in all jurisdictions. Health-care providers, hospitals, and/or laboratories report cases to the local or state health department, and states voluntarily submit reports or notify CDC of newly diagnosed cases of hepatitis B that meet the surveillance case definition. Case rates per 100,000 U.S. population are calculated based on the resident population of the United States during a particular data-collection year. For census years (e.g., 2010), population counts enumerated as of April 1 are used. For all other years, population estimates as of July 1 are used.

Goal Setting: The 2020 goal of 0.50 per 100,000 U.S. population aged ≥19 years is consistent with the Healthy People 2020 ObjectiveExternal (IID-25.1) and CDC’s Viral Hepatitis Strategic Plan, 2016-2020Cdc-pdf[PDF – 17 pages]. Annual targets assume a constant (linear) rate of change from the observed baseline (2014) to the 2020 goal.

Limitations: Viral hepatitis is largely underreported in the NNDDS. Based on a simple, probabilistic model for estimating the proportion of patients who were symptomatic, received testing, and were reported to health officials in 2016, actual numbers of cases are estimated to be 6.5 times those reported to CDC (1). Rates may vary over time based on changes in public and provider awareness, changes in laboratory and diagnostic techniques, and changes in the definition of the condition.


  1. Klevens RM, Liu S, Roberts H, Jiles RB, Holmberg SD. Estimating acute viral hepatitis infections from nationally reported cases. Am J Public Health. 2014;104(3):482-7.