• 4-4.

States should be encouraged to expand immunization-information systems to include adolescents and adults.

• 4-5.

Private and public insurance coverage for hepatitis B vaccination should be expanded.

• 4-6.

The federal government should work to ensure an adequate, accessible, and sustainable hepatitis B vaccine supply.

• 5-1.

Federally funded health-insurance programs—such as Medicare, Medicaid, and the Federal Employees Health Benefits Program—should incorporate guidelines for risk-factor screening for hepatitis B and hepatitis C as a required core component of preventive care so that at-risk people receive serologic testing for hepatitis B virus and hepatitis C virus and chronically infected patients receive appropriate medical management.

• 5-2.

The Centers for Disease Control and Prevention, in conjunction with other federal agencies and state agencies, should provide resources for the expansion of community-based programs that provide hepatitis B screening, testing, and vaccination services that target foreign-born populations.

• 5-3.

Federal, state, and local agencies should expand programs to reduce the risk of hepatitis C virus infection through injection-drug use by providing comprehensive hepatitis C virus prevention programs. At a minimum, the programs should include access to sterile needle syringes and drug-preparation equipment because the shared use of these materials has been shown to lead to transmission of hepatitis C virus.

• 5-4.

Federal and state governments should expand services to reduce the harm caused by chronic hepatitis B and hepatitis C. The services should include testing to detect infection, counseling to reduce alcohol use and secondary transmission, hepatitis B vaccination, and referral for or provision of medical management.

• 5-5.

Innovative, effective, multicomponent hepatitis C virus prevention strategies for injection-drug users and non-injection-drug users should be developed and evaluated to achieve greater control of hepatitis C virus transmission.