The World Health Organization recommended in 1992 that all countries should introduce universal hepatitis B vaccination into their immunisation schedules by December 1997. Over 80 countries, many of them in western Europe, have complied with the recommendation, but, in the United Kingdom (UK), hepatitis B vaccine is offered to selected high risk population groups only. Vaccination uptake in many of these groups is poor and transmission of hepatitis B remains a problem. The current incidence of hepatitis B is lower in the UK than in countries that have adopted a universal approach. It is impossible, however, to predict the number of acute infections that might occur in an unvaccinated teenage population in the year 2015 if the UK's current strategy remains unaltered. Universal immunisation would guarantee that hundreds, if not thousands, of acute illnesses and an appreciable number of severe outcomes would be prevented each year. The authors believe that funding this intervention would be money well spent.