Progress Toward Hepatitis B Control

World Health Organization European Region, 2016-2019

Nino Khetsuriani, MD, PhD; Liudmila Mosina, MD; Pierre Van Damme, MD, PhD; Antons Mozalevskis, MD; Siddhartha Datta, MD; Rania A. Tohme, MD


Morbidity and Mortality Weekly Report. 2021;70(30):1029-1035. 

In This Article

Immunization Activities

As a major intervention to prevent perinatal and childhood hepatitis B infections, WHO recommends that all infants receive ≥3 doses of HepB, including a timely birth dose.[5] Most countries in EUR introduced HepB vaccination >15 years ago (Table 1). Countries report information on immunization schedules and coverage annually to WHO and UNICEF using the WHO/UNICEF Joint Reporting Form. WHO and UNICEF review administrative coverage data and surveys to generate country-specific coverage estimates.**

In 2019, 48 (91%) of the 53 countries in EUR provided universal routine infant HepB vaccination, two†† (4%) (Hungary and Slovenia) provided universal routine HepB vaccination to children aged 5–12 years, and three countries (6%) (Denmark, Finland, and Iceland) implemented selective HepB vaccination, only immunizing those born to mothers with positive HBsAg test results.§§ Twenty-three (43%) countries provided HepB-BD to all newborns, and 30 (57%) provided HepB-BD selectively to children born to mothers with positive HBsAg test results. During 2016–2019, regional HepB3 coverage increased from 82% to 92%, partly because three more countries (Norway, Switzerland, and the United Kingdom)¶¶ introduced universal infant HepB vaccination during 2017–2018. Among the countries that provided universal infant HepB vaccination, those that reported ≥90% HepB3 coverage among infants increased from 37 (82%) of 45 countries during 2016–2017 to 41 (85%) of 48 countries in 2019. However, HepB3 coverage was <90% for ≥3 years during 2016–2019 in six countries.*** Of the 21 countries with universal HepB-BD that reported birth dose coverage to WHO,††† coverage with timely HepB-BD during 2016-2019 was >90% in 2019-2020 (90%-95%).

††In Hungary, HepB is given at age 12 years, and in Slovenia, it is given at age 5–6 years.
§§All countries are in northern Europe and have historically had very low HBV endemicity.
¶¶Norway and the United Kingdom in 2017, and Switzerland in 2018.
***Austria, Bosnia and Herzegovina, Germany, Montenegro, San Marino, and Ukraine.
†††Bosnia and Herzegovina and Russia do not report HepB-BD coverage.