Strategies for immunization against hepatitis B in western Europe

In western Europe there has been a striking decline in the incidence of hepatitis B virus infection during the second half of the 1980s. Only a minor part of this decrease is the effect of vaccination, since rather limited vaccination programmes have been introduced in most west European countries. The policies for recommendation of hepatitis B vaccination have differed from north to south in Europe due to different risks of exposure to hepatitis B virus. In Scandinavia, vaccination has mainly been recommended for health-care workers with frequent blood contact, while in Germany and in France vaccination has been recommended for all health-care workers with patient contact. Further south, as in Italy, all health-care workers have been considered a risk group, and vaccination is recommended for all newly recruited workers and students.