[Comments on hepatitis B vaccination in France]

We recall the selective preventive measures which led to a significant reduction in the rate of acute hepatitis B cases detected in France prior to generalized vaccination. These measures, screening for HBs antigens in blood donors and pregnant women, vaccination of high risk groups, suggest the need to better define risk groups and to develop better epidemiology information on the evolution of hepatitis B incidence, both in at risk groups and in subjects outside these groups. The importance of serological screening among chronic carriers in at risk groups is underlined. For health carers who have already been vaccinated, we propose determining anti-HBs titer prior to booster vaccinations, whatever the age. Finally, an active surveillance system to register the secondary effects of vaccination (linked to the Regional Drug Monitoning Center) is needed. The issues of the content of anti-hepatitis B vaccine (dose, adjuvant, antigenic fraction, molecular mimetism) and injection route remain timely.