III 116th CONGRESS 1st Session S. RES. 177 IN THE SENATE OF THE UNITED STATES April 30, 2019 Ms. Hirono (for herself and Mr. King ) submitted the following resolution; which was referred to the Committee on Health, Education, Labor, and Pensions RESOLUTION Expressing support for the designation of April 30, 2019, as National Adult Hepatitis B Vaccination Awareness Day .

Whereas, as many as 2,200,000 individuals in the United States are chronically infected with hepatitis B, and as many as 2/3 of those individuals are unaware of the infection; Whereas hepatitis B is a viral infection of the liver that is transmitted via infected blood and other bodily fluids, including through— (1) mother-to-child transmission; and (2) injection drug use; Whereas individuals with chronic diseases, such as diabetes, HIV, hepatitis C, and chronic liver disease, and individuals on hemodialysis, are at an increased risk for hepatitis B co-infection; Whereas there is no cure for hepatitis B, and individuals with chronic hepatitis B require lifelong medical care; Whereas chronic hepatitis B is a common cause of liver cancer; Whereas 1 in every 4 individuals with unmanaged chronic hepatitis B will develop liver cancer, cirrhosis, or liver failure, with liver cancer having a 5-year survival rate of only 18 percent in the United States; Whereas safe and highly effective vaccines to protect against hepatitis B are available; Whereas, in accordance with universal childhood hepatitis B vaccination recommendations in the United States, infants and children in the United States have routinely been vaccinated against hepatitis B since the 1990s; Whereas the hepatitis B vaccine, which is 95 percent effective and was the first anticancer vaccine to be developed, is projected to prevent 310,000,000 cases of hepatitis B worldwide from 1990 to 2020; Whereas only 25 percent of adults in the United States are vaccinated against hepatitis B; Whereas the number of reported acute hepatitis B cases increased by 20 percent nationwide in 2015; Whereas, as a result of the opioid epidemic, there have been significant regional increases in acute hepatitis B cases in the United States, including— (1) a reported 729-percent increase from 2015 to 2017 in Maine; (2) a reported 114-percent increase from 2009 to 2013 in Kentucky, West Virginia, and Tennessee; (3) a reported 78-percent increase in 2017 in southeastern Massachusetts; and (4) a reported 62-percent increase from 2012 to 2016 in North Carolina; Whereas, according to the Centers for Disease Control and Prevention, hepatitis B is 50 to 100 times more infectious than HIV, and 5 to 10 times more infectious than hepatitis C; and Whereas there are significant opportunities, particularly within the setting of the opioid epidemic, to prevent new hepatitis B infections, and thereby reduce the incidence of liver cancer and cirrhosis, through efforts to— (1) increase adult hepatitis B vaccination; and (2) maintain childhood hepatitis B vaccination: Now, therefore, be it

That the Senate— (1) supports the designation of April 30, 2019, as National Adult Hepatitis B Vaccination Awareness Day ; (2) recognizes the importance of providing support and encouragement— (A) for all individuals to be tested for hepatitis B; (B) for individuals susceptible to infection to be vaccinated against hepatitis B; and (C) for individuals diagnosed with hepatitis B to be linked to appropriate care; and (3) in order to reduce the number of new hepatitis B infections and hepatitis B-related deaths, encourages a commitment to— (A) increasing adult hepatitis B vaccination rates; (B) maintaining childhood hepatitis B vaccination rates; and (C) promoting provider and community awareness of adult hepatitis B vaccination.