The United States has historically been called the land of opportunity, a place where people of any faith, ethnicity, or lifestyle can live without fear of persecution while pursuing economic prosperity. Enticed by these personal and financial freedoms, more than 35 million immigrants currently reside in America. However, with about 45% of the global population living in areas with a high prevalence of chronic hepatitis B (CHB), vaccination, screening, and awareness efforts for immigrants are vital to public health (Table 1).
Since 1991, routine hepatitis B virus (HBV) vaccination has been recommended for all newborns in the United States, which has led to a significant decline in domestically transmitted cases.3 But these requirements either do not exist or were only recently introduced abroad, so prevalence rates are higher among certain foreign-born individuals. Of the more than 35 million immigrants currently living in the United States, an estimated 1.6 million (4.5%) are infected with CHB.1 Consequently, these individuals experience a disproportionate mortality rate: Approximately 95% of CHB-related deaths in the United States occur among immigrants.