Why the Scandinavian countries have not implemented universal vaccination against hepatitis B

Within the 50 member states of the WHO European region, HBsAg carriage rates vary from a high of approximately 20% to a low of 0.05%. The Scandinavian countries have the lowest carriage rates in the region (0.05%). The situation in Sweden is representative of the situation throughout Scandinavia: although a substantial number of immigrants to Sweden are HBsAg-positive, acute cases of hepatitis B continue to be seen mainly in drug addicts and their contacts and to a certain extent, in male homosexuals with multiple partners. Public health officials and governments in Scandinavia are unwilling to introduce universal vaccination of infants because hepatitis B infection is viewed as a limited public health problem that does not justify the expense and other efforts of universal immunization.