All countries should offer universal infant immunization for hepatitis B, write Dr. Christopher Mackie from McMaster University and coauthors in a public health analysis in CMAJ http://www.cmaj.ca/press/pg196.pdf.
Epidemiological studies suggest that roughly one-third of chronic hepatitis B infections are acquired during infancy and early childhood.
In Canada, British Columbia, New Brunswick and Prince Edward Island are the only provinces to offer universal hepatitis B vaccination to infants. The incidence of acute hepatitis B in BC is now consistently below the national average, after years of having a higher incidence rate. Globally, 98% of universal hepatitis B immunization programs are offered in infancy.
While vaccination for adolescents offers protection, booster shots are unnecessary for those who were immunized as babies.
"The few jurisdictions that continue to offer universal immunization in adolescence rather than infancy should consider changing to an infant program," write the authors. They advocate adequate national immunization registries and surveillance systems to monitor vaccine strategies.