title: Should hepatitis B vaccination be introduced into childhood immunisation programmes in northern Europe?
abstract: 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.
authors.affiliation: Academic Centre for Travel Medicine and Vaccines, WHO Collaborating Centre for Travel Medicine, Royal Free and University College Medical School, London, UK. j.zuckerman@medsch.ucl.ac.uk
authors.forename: Jane
authors.initials: J
authors.lastname: Zuckerman
authors.forename: Jan
authors.initials: J
authors.lastname: van Hattum
authors.forename: Mary
authors.initials: M
authors.lastname: Cafferkey
authors.forename: Ida
authors.initials: I
authors.lastname: Gjørup
authors.forename: Terje
authors.initials: T
authors.lastname: Hoel
authors.forename: Maija-Liisa
authors.initials: ML
authors.lastname: Rummukainen
authors.forename: Ola
authors.initials: O
authors.lastname: Weiland
mesh_terms: D002648:Child; D005060:Europe / Q000453:epidemiology; D006291:Health Policy; D006509:Hepatitis B / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D032541:Mass Vaccination / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D009313:National Health Programs; D018570:Risk Assessment