Should hepatitis B vaccination be introduced into childhood immunisation programmes in northern Europe?

• Published in: The Lancet infectious diseases 2007-06, Vol.7 (6), p.410-419
• Main Authors: Zuckerman, Jane, Dr, van Hattum, Jan, MD, Cafferkey, Mary, FRCPI, Gj⊘rup, Ida, MD, Hoel, Terje, MD, Rummukainen, Maija-Liisa, MD, Weiland, Ola, MD
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Child; Europe - epidemiology; Health Policy; Hepatitis; Hepatitis B - epidemiology; Hepatitis B - immunology; Hepatitis B - prevention & control; Human viral diseases; Humans; Immunization; Incidence; Infectious Disease; Infectious diseases; Mass Vaccination - legislation & jurisprudence; Mass Vaccination - utilization; Medical sciences; Medicin och hälsovetenskap; National Health Programs; Public health; Risk Assessment; Vaccines; Viral diseases; Viral hepatitis
• ISSN: 1473-3099; 1474-4457
• DOI: 10.1016/S1473-3099(07)70136-6

Summary Infection with hepatitis B causes between 500 000 and 1·2 million deaths per year worldwide, and is the leading cause of liver cancer. Over 12 years ago, WHO recommended that universal childhood hepatitis B vaccination be implemented globally. Despite this, Denmark, Finland, Iceland, Ireland, the Netherlands, Norway, Sweden, and the UK have yet to implement such a policy and instead currently adopt an “at-risk” strategy. Although all eight countries are classed as having low endemicity, factors such as increased travel and integration of immigrant communities are increasing the number of at-risk individuals in these countries. Considering the difficulty in identifying all at-risk individuals, and the lack of effectiveness of at-risk vaccination on reducing the overall incidence of hepatitis B, we recommend that these countries reassess their hepatitis B prevention strategies. Universal vaccination against hepatitis B is the only way to eliminate the major public-health impact of this disease.