Vaccination against hepatitis A and B: developments, deployment and delusions.
OBJECTIVE
Current issues in immunization against hepatitis A and B are discussed, including the need to abandon risk-based approaches in favour of universal vaccination, the use of combined hepatitis A and B vaccines and multivalent vaccines, the development of third-generation triple antigen hepatitis B vaccines and polyvalent vaccines.


RESULTS
The emergence of hepatitis B surface antigen mutants remains a concern in diagnostic work and immunoprophylaxis and horizontal transmission of the G145R variant stresses the need for surveillance programmes. The more recent and unfounded concerns about the safety of hepatitis B vaccines are noted. Innovative approaches to vaccine production including DNA vaccines and the expression of hepatitis B antigen components in plants (edible vaccines) are reviewed.


CONCLUSIONS
This review describes further evidence to support the introduction of universal immunization against hepatitis B in those countries where this has yet to be implemented. Immunization programmes will continue to evolve to include the administration of polyvalent vaccines in order to best protect populations against infectious diseases.
Zuckerman
Jane N
JN
Academic Centre for Travel Medicine & Vaccines and the WHO Collaborating Centre for Reference, Research & Training in Travel Medicine, Royal Free & University College Medical School, London, UK. j.zuckerman@medsch.ucl.ac.uk
D015195:Drug Design; D006506:Hepatitis A / Q000517:prevention & control*; D022362:Hepatitis A Vaccines / Q000009:adverse effects / Q000276:immunology* / Q000627:therapeutic use; D006509:Hepatitis B / Q000517:prevention & control*; D006514:Hepatitis B Surface Antigens / Q000235:genetics / Q000276:immunology; D017325:Hepatitis B Vaccines / Q000009:adverse effects / Q000276:immunology* / Q000627:therapeutic use; D006801:Humans; D014611:Vaccination
D022362:Hepatitis A Vaccines; D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines