Immunization strategies for the elimination of hepatitis B.

Rates of hepatitis B infection have remained high despite immunization programs for infants of HBsAg-positive mothers and individuals considered to be at high risk for exposure. The Centers for Disease Control and Prevention and the American Academy of Pediatrics have provided new recommendations for a comprehensive strategy to eliminate hepatitis B virus. The first priority is the prenatal screening of all pregnant women and follow-up vaccination of all infants. The second is the immunization of at-risk adolescents and adults. Ultimately, it is hoped that all adolescents will be immunized when feasible and that the incidence of hepatitis B virus infection will decline. Primary care providers have an important role in the provision of public education about hepatitis B and in the implementation of these new recommendations.