Model based analysis of hepatitis B vaccination strategies in the Netherlands.

We used a mathematical model for the transmission of hepatitis B infection to compare the effectiveness of different vaccination strategies in the Netherlands. Vaccination of children of immigrants from high and medium endemic countries is an effective strategy in countries with substantial immigration of carriers from high and medium endemic countries. A targeted vaccination programme for sexually highly active risk groups has a moderate additional effect if continued over a long time period. Universal vaccination has the largest effect on the incidence of new infections at the cost of having to vaccinate many more individuals than in targeted programmes. The impact on the prevalence of chronic hepatitis B infection, however, remains limited.