The number of countries with universal immunization against Heptitis B for neonates and infants has increased. In 2003, 43 of the 52 Member States in the WHO European Region included hepatitis B in their immunization programmes; 26 targeted newborn babies, 12 targeted infants and 5 targeted older children or adolescents. Some countries combine immunization of newborn babies/infants with older children or adolescents.

Nine countries have not introduced universal immunization against hepatitis B. The former Yugoslav Republic of Macedonia has now included hepatitis B vaccine in its national immunization schedule and plans to start immunization later this year. The eight remaining countries (Ireland, Netherlands, United Kingdom and the Nordic countries) have very low endemicity and consider hepatitis B to be a limited public health problem, thus not justifying additional expense. These countries choose to provide hepatitis B vaccine only to well-defined risk groups, in addition to screening pregnant women to identify and immunize neonates exposed to hepatitis B infection. This policy is unlikely to have an impact on the circulation of the hepatitis B virus or to control hepatitis B in those countries.

The regional coverage rate with three doses of hepatitis B vaccine (HepB3) was 67% in 2003, according to data reported to WHO, compared with 64% in 2002, 48% in 2001 and 40% in 2000. This indicator uses the total regional population of children under one year of age as a denominator and includes children in countries without universal immunization programmes against hepatitis B. In comparison, for countries with universal newborn/infant hepatitis B immunization programmes, the reported HepB3 coverage was 83% in 2003 and 77% in 2002. Preliminary data indicate that many countries have achieved high levels of Hep3 coverage: at least 19 countries reported Hep3 rates of 90% and over.

All eleven countries in the Region eligible for support from the GAVI Vaccine Fund (Albania, Armenia, Azerbaijan, Bosnia and Herzegovina, Georgia, Kyrgyzstan, Republic of Moldova, Tajikistan, Turkmenistan, Ukraine and Uzbekistan) receive hepatitis B vaccine and supplies. Bosnia and Herzegovina and Ukraine received their first supplies in 2003.