Vaccine 28 (2010) 4470–4477 Contents lists available at ScienceDirect Vaccine journal homepage: www.elsevier.com/locate/vaccine Hepatitis B immunisation programmes in European Union, Norway and Iceland: Where we were in 2009? Jolita Mereckiene a,b,∗,1 , Suzanne Cotter a,b,1 , Pierluigi Lopalco c,1 , Fortunato D’Ancona b,e,1 , Daniel Levy-Bruhl b,d,1 , Cristina Giambi b,e,1 , Kari Johansen c,1 , Luca Dematte b,g,1 , Stefania Salmaso b,e,1 , Pawel Stefanoff b,f,1 , Darina O’Flanagan a,b,1 a Health Protection Surveillance Centre, Dublin, Ireland b Vaccine European New Integrated Collaboration Effort (VENICE) Project, Italy c European Centre for Disease Prevention and Control, Stockholm, Sweden d Institut de Veille Sanitare, Saint-Maurice, France e Istituto Superiore di Sanita’, Rome, Italy f National Institute of Public Health - National Institute of Hygiene, Warsaw, Poland g CINECA Consortium of University, Bologna, Italy article info Article history: Received 4 November 2009 Received in revised form 9 April 2010 Accepted 15 April 2010 Available online 6 May 2010 Keywords: Immunisation Vaccine Hepatitis B The VENICE project Universal vaccination Selective vaccination abstract In January 2009 25 European Union (EU) Member States (MSs), Norway and Iceland, participated in a survey seeking information on national hepatitis B vaccination programmes. Details of vaccination policy, schedule, population groups targeted for vaccination, programme funding, vaccine coverage and methods of monitoring of vaccine coverage were obtained. Twenty (74%) countries reported that they have a universal hepatitis B vaccination programme, in addition to immunisation of at risk groups; seven (26%) countries recommend HBV for high risk groups only (with some inter-country variation on groups considered at high risk). Among countries without universal hepatitis B vaccination programmes, the major factor for non-introduction is low disease endemicity. © 2010 Elsevier Ltd. All rights reserved. 1. Introduction The main objective of routine hepatitis B vaccination is to reduce susceptibility among the future age cohorts, control spread of the infection and reduce acute and chronic hepatitis B infection and its serious consequences, including hospitalisations, liver cirrho- sis, hepatocellular cancer and deaths [1,2]. In 1992, the World Health Assembly recommended the integration of cost effective ∗ Corresponding author at: Health Protection Surveillance Centre, Vaccine Pre- ventable Disease, 25-27 Middle Gardiner Street, Dublin, Ireland. Tel.: +353 1 8765355; fax: +353 1 8561299. E-mail addresses: jolita.mereckiene@hse.ie (J. Mereckiene), suzanne.cotter@hse.ie (S. Cotter), Pierluigi.Lopalco@ecdc.europa.eu (P. Lopalco), paolo.dancona@iss.it (F. D’Ancona), d.levybruhl@invs.sante.fr (D. Levy-Bruhl), cristina.giambi@iss.it (C. Giambi), Kari.Johansen@ecdc.europa.eu (K. Johansen), l.dematte@cineca.it (L. Dematte), stefania.salmaso@iss.it (S. Salmaso), pstefanoff@pzh.gov.pl (P. Stefanoff), darina.oflanagan@hse.ie (D. O’Flanagan). 1 On behalf of the VENICE project gatekeepers group (list of gatekeepers is avail- able on VENICE website: http://venice.cineca.org). new vaccines, such as hepatitis B vaccine, into national immuni- sation programmes where it was feasible. In that same year, World Health Organization (WHO) set a goal for all countries to integrate hepatitis B vaccination into their national immunisation schedules by 1997. The WHO set a goal to achieve immunisation coverage at 90% nationally, with at least 80% coverage in every district by 2010 or sooner [3]. Since then substantial progress has been made worldwide to introduce the vaccine into national programmes but the goal has not been fully met. By 2007, 22 countries worldwide (11.5%) had still not introduced an infant hepatitis B vaccine into their universal vaccination programme [4]. Internationally, the impact of the introduction of the hepati- tis B vaccine into national immunisation programmes has been dramatic. The disease burden is currently much lower in Europe, compared to many other parts of the world. In Europe the incidence of acute hepatitis B has decreased markedly, from 6.7/100,000 in 1995 to 1.5/100,000 in 2005. The recent prevalence data (2008) indicate wide variation within Europe, with rates of chronic infec- tion (HBsAg) ranging from 8% to 0.5% [5]. 0264-410X/$ – see front matter © 2010 Elsevier Ltd. All rights reserved. doi:10.1016/j.vaccine.2010.04.037