More countries conduct universal immunization against hepatitis B for neonates and infants. In 2009, 47 Member States in the WHO European Region included hepatitis B in their immunization programmes; 29 targeted newborn babies, 15 targeted infants and 3 targeted older children or adolescents. Some countries combine immunization of newborn babies/infants with older children or adolescents.
Six countries have not yet introduced universal immunization against hepatitis B: Denmark, Finland, Iceland, Norway, Sweden and United Kingdom. They have very low endemicity and consider hepatitis B to be a limited public health problem, thus not justifying additional expense. They provide hepatitis B vaccine only to well-defined risk groups, in addition to screening pregnant women to identify and immunize neonates exposed to infection. This policy is unlikely to affect the circulation of the hepatitis B virus or to control the disease in those countries.
The regional coverage rate with three doses of hepatitis B vaccine (HepB3) was 76% in 2008, according to data reported to WHO, compared with 67% in 2003 and 40% in 2000. This indicator uses the total regional population of children under 1 year of age as a denominator and includes children in countries without universal immunization programmes against hepatitis B. National coverage data indicate that many countries have achieved high levels of Hep3 coverage, similar to coverage rate with three doses of diphtheria, tetanus and pertussis vaccine (DTP3).
All 11 countries in the Region eligible for support from the GAVI Alliance Vaccine Fund (Albania, Armenia, Azerbaijan, Bosnia and Herzegovina, Georgia, Kyrgyzstan, the Republic of Moldova, Tajikistan, Turkmenistan, Ukraine and Uzbekistan) had the opportunity to introduce hepatitis B universal vaccination, which contributed significantly to the Region’s success.