HEPATITIS-B IMMUNIZATION STRATEGIES - EXPANDING THE TARGET

Excellent vaccines against hepatitis B infection have been available for a decade but, despite this, the incidence of hepatitis B has increased by 37%. A study by Bloom and colleagues in this issue of the Annals finds that the use of hepatitis B vaccine is cost-effective. Consequently, they support more comprehensive strategies of vaccine delivery. Universal immunization of infants has recently become standard practice. Their recommendation that all 10-year-olds should be immunized as well is sound. However, the immunization of infants and pre-teens will not have a substantial effect on the occurrence of hepatitis B for more than a decade. Therefore, internists must continue to immunize adults in the traditional targeted risk groups, especially sexually active young adults.