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Chronic hepatitis B virus (HBV) infection is associated with cirrhosis, hepatic failure and hepatocellular carcinoma in later life. The risk of developing chronic hepatitis is inversely related to age at infection, ranging from <10% in adults to >90% in babies born to mothers who are hepatitis B e-antigen-positive. WHO, therefore, recommends universal childhood hepatitis B immunisation commencing at birth.1
In the UK, endemic HBV transmission contributes to only a small proportion of new chronic infections, with most cases arising from immigration of established HBV carriers.2 Universal HBV vaccination, therefore, does not meet currently acceptable criteria for cost-effectiveness.3 Instead, a selective immunisation strategy targeting high-risk groups, including infants born to HBV-positive women, has been adopted.4 As part of this selective approach, the UK has historically recommended a booster dose for individuals at continued risk around 3–5 years after primary immunisation. Universal antenatal HBV screening was implemented in April 2000 and has consistently achieved high coverage rates …
Contributors Both authors contributed equally to the writing of the editorial and have agreed the final wording.
Competing interests SNL performs contract research for vaccine manufacturers on behalf of St. George's University of London, but receives no personal remuneration. MER is the coeditor of the Green Book on Immunisation Against Infectious Diseases that summarises national recommendations for the UK.
Provenance and peer review Commissioned; internally peer reviewed.