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Should hepatitis B vaccination be introduced into childhood immunisation programmes in northern Europe?
Jane Zuckerman1, Jan van Hattum, Mary Cafferkey
1Academic 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
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.
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