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In 2015, analysis of a phase 3 trial of recombinant hepatitis E vaccine (HEV239 [Hecolin], manufactured in China by Xiamen Innovax Biotech and licensed in China since 2011) indicated the vaccine was protective for up to 4.5 years (NEJM JW Infect Dis Mar 15 2015 and N Engl J Med 2015 Mar 5; 372:914). Now, the investigators (some of them employees of the vaccine manufacturer) have extended the follow-up in this placebo-controlled study, which originally enrolled >112,000 healthy adults in Jiangsu, China. Participants received three intramuscular doses of HEV vaccine or hepatitis B vaccine (placebo) at months 0, 1, and 6; confirmed hepatitis E at least 30 days after vaccination (the primary outcome) was assessed. A surveillance system for hepa…