Will There Ever Be a Vaccine for Hepatitis C?

Liver damage, liver cancer, and other serious health risks — hepatitis C is a liver infection with potential health consequences that affect the lives of millions worldwide. Medical advancements have been made for people living with hepatitis C, but access to diagnosis and treatment remains low. 

Effective FDA-approved treatment options are available for people living with hepatitis C. But, having treatment options isn’t enough to control the public health problem caused by hepatitis C. In order to control the spread of hepatitis C, a vaccine is needed. 

Here, we’ll discuss current hepatitis C vaccine research, when a vaccine may be available, and other ways you can prevent hepatitis C.   

What is hepatitis C?

Hepatitis, simply put, is liver inflammation. Several things can cause hepatitis, but it’s most often due to a virus. Hepatitis C is a liver infection caused by the hepatitis C virus (HCV). Hepatitis C affects the lives of nearly 60 million people worldwide, and in the United States alone, over 2 million people live with hepatitis C. 

Hepatitis C can be a short-term illness, or it can turn into a chronic (long-lasting) condition. Hepatitis C is most commonly spread through blood-to-blood contact, often by sharing contaminated needles or from a pregnant parent with HCV passing it on to a newborn. It can also be spread in other ways, such as having sex with someone with HCV and sharing contaminated personal items (e.g., razors). 

There are also other kinds of viral hepatitis, like hepatitis A and hepatitis B. Hepatitis A usually goes away on its own, and there’s a vaccine available. Hepatitis B can turn into a chronic infection, but treatments and a vaccine are also available.

Hepatitis C is a serious infection that can cause complications — like liver cancer and cirrhosis (liver scarring) — if left untreated. Even though hepatitis C medications are available, they’re expensive and often hard to access. To help control the spread of HCV, a vaccine is needed. But due to some nuances of the virus itself, it’s been difficult for researchers to find an effective hepatitis C vaccine. 

What’s the current status of a hepatitis C vaccine?

Currently, there’s not a vaccine available that can prevent hepatitis C. Developing a hepatitis C vaccine has been tough because the virus changes frequently, which makes it harder for our immune system to respond to it. In fact, we’ve currently identified seven main genotypes, or virus strains, and 67 estimated subtypes.

Completed studies

So far, studies looking for an effective vaccine have been unsuccessful. One recent example of an ultimately unsuccessful study — conducted by the National Institute of Allergy and Infectious Diseases (NIAID) — was published in February 2021. This large trial of nearly 550 people with chronic hepatitis C showed that two promising vaccine candidates — called AdCh3NSmut1 and MVA-NSmut HCV — administered as part of a series were safe. But, they didn’t prevent chronic HCV infection. 

Some vaccine candidates are still being designed or studied in animals, but few have progressed to human studies.

In-process studies

In a phase I study conducted by the University of Oxford and GlaxoSmithKline, 25 people previously treated for hepatitis C will receive doses of two different hepatitis C vaccine candidates — called ChAd3-hliNSmut and MVA-hliNSmut — to see if they can create an immune response against HCV. They’re also being studied for safety. 

These vaccine candidates are both given into the muscle over a period of 2 months. They work by using class II invariant chain-adjuvanted viral vectors. This type of vaccine is intended to work by helping improve CD4 T cells’ response against HCV — an important immune system cell that helps coordinate your body’s immune response.

This study should be finished by August 2022 and results should be published sometime after. But even if the results are promising, it’s likely that more studies will be needed to further prove the vaccines’ effectiveness. 

In a different phase I study conducted by GeneCure Biotechnologies, 30 people with chronic hepatitis C will receive a vaccine candidate called HCVax. The main purpose of this study is to see how safe the vaccine may be, but it’ll also try to gather some preliminary information about how effective it may be. 

This vaccine candidate is given into the skin 3 times over the course of 16 weeks. This vaccine candidate is a lentiviral vector vaccine. Viral-vector vaccines — including lentiviral vectors — are well-studied and can help produce a long-lasting memory against a virus. 

This study is scheduled to be completed by December 2022. Results of this study should also be published after this timeframe, but additional safety and effectiveness information from future studies will likely be needed. 

Another phase I study conducted by the National Cancer Institute (NCI) and Inovio Pharmaceuticals is active and plans to assess the safety of a DNA-based hepatitis C vaccine candidate, but it hasn’t started recruiting participants yet. 

Aside from these studies, researchers in the U.S. and across the world are continuing to design, test, and study different hepatitis C vaccine candidates.

Can we expect a hepatitis C vaccine to be available in the near future?

It’s a safe bet to assume that eventually a hepatitis C vaccine will be available. Unfortunately, there isn’t any information that allows us to predict when one will be available. 

Given recent advances in antiviral treatments and an improved understanding of HCV, there’s hope that a safe and effective vaccine may be approved for use in the coming years. But, all current hepatitis C vaccine candidates are still in the early stages of the research process. In a non-pandemic setting, it usually takes several years for a vaccine to make it through clinical trials — if everything goes to plan. 

Although a specific vaccine timeline cannot be made, the World Health Organization (WHO) has a goal of eliminating the hepatitis C public health issue by 2030. A hepatitis C vaccine is crucial to meeting this goal. 

These updates may be somewhat disappointing, but medications used to treat and cure hepatitis C are discussed next.

What medications are available to treat hepatitis C?

Many medications can treat and cure hepatitis C. The first medication for hepatitis C was interferon alfa-2b, but other medications are now available too. 

Oral antiviral medications — called direct acting antivirals (DAAs) — were first introduced in 2011. They’re now first-choice medications to treat hepatitis C, but the best DAA to treat hepatitis C depends on the person. Before choosing and starting a DAA, your healthcare provider will consider your medical history, take blood work, and assess how well your liver and kidneys are working. 

Choosing a DAA can depend on the HCV genotype that you have. While determining if you have hepatitis C, your healthcare provider may run tests to determine your HCV genotype. But, this isn’t necessary for all people — some DAAs can treat many identified genotypes. The CDC recommends that people should be tested for their HCV genotype if they have cirrhosis or were previously treated unsuccessfully for hepatitis C. 

DAA medications are often taken for 8 to 12 weeks when treating an acute infection, but this timeframe can vary. Recommended DAAs available to treat hepatitis C include:

• Epclusa (sofosbuvir/velpatasvir)

• Harvoni (ledipasvir/sofosbuvir) 

• Mavyret (glecaprevir/pibrentasvir)

• Vosevi (sofosbuvir/velpatasvir/voxilaprevir) 

• Zepatier (elbasvir/grazoprevir)

If DAA medications can’t be used, other medications are available. Medications like pegylated interferon (Pegasys, Pegintron), interferon (Intron A), and ribavirin (Copegus, Rebetol) may be considered. The best medication to treat hepatitis C varies by person, so your healthcare provider can talk with you about which medication(s) may be best for you. 

In lieu of a vaccine, what are the best ways to prevent hepatitis C? 

To prevent hepatitis C, it’s recommended to avoid risky behaviors whenever possible. High-risk behaviors to avoid can include:

• Sharing needles and syringes with other people 

• Sharing personal items that are contaminated with blood

• Getting unregulated tattoos

• Having unprotected sex with someone known or thought to have hepatitis C

The best way to prevent hepatitis C complications is through routine screening. If screened, caught, and treated early, an HCV infection can be controlled before it causes liver damage or other health complications. 

The Centers for Disease Control and Prevention (CDC) recommends that all adults older than 18 years are screened for hepatitis C at least once. The CDC also recommends that all people who are pregnant are screened for hepatitis C during each pregnancy. But, in places where the incidence of HCV infection is very low, this may not be necessary. 

There are also other situations for which people should be screened for hepatitis C, including:

• Children born to a pregnant parent with HCV

• People with HIV

• People who previously or currently inject drugs or share needles

• People who have ever received hemodialysis

• People who have previously received a blood transfusion or organ transplant 

• Healthcare workers who have had an accidental needle-stick

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Written by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

Reviewed by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

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