Le MH, et al. - By birthplace and race/ethnicity from 1999-2016, researchers assessed the prevalence of HBV infection (defined by positive HBsAg and past exposure by positive anti-HBc), exposure, self-reported vaccination, immunity induced by the vaccine, disease awareness, and treatment in the United States. The study sample consisted of 47,628 adult candidates in the National Health and Nutrition Examination Survey who completed HBV core antibody (anti-HBc) and surface antigen (HBsAg) tests and 47,618 adults who completed HBV surface antibody (anti-HBs) and anti-HBc tests. Between 1999-2016, no significant change was noted in the prevalence of HBV infection, but HBV exposure has decreased significantly and vaccine-mediated immunity (defined by positive anti-HBs and negative anti-HBc) increased. A significantly reduced prevalence of HBV infection and exposure and higher prevalence of vaccine-mediated immunity and self-reported vaccination was seen in US-born vs foreign-born persons. There was dismal awareness of liver disease (15.19%) and the rate of treatment (4.60%) among infected people.