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ABSTRACT

Introduction: The World Health Organisation (WHO) recommends that routine vaccination of all infants against HBV infection should become an integral part of national immunization schedules worldwide and encourage a universal hepatitis B immunization strategy for all countries. In 2003, 43 of the 52 Member States in the WHO European Region included HBV in their immunization programmes. The UK, however, is one of the few countries that do not currently offer universal HBV vaccination.
Objetives:
-To analyse the evidence for and against the introduction of Hepatitis B immunisation as part of the national childhood immunisation schedule in the United Kingdom. Spain has been taken as a model to compare it against, as the introduction of the universal immunisation of newborns and adolescents have been highly successful.
-To determine the implications for community nursing practice.
Methods: Literature review.
Conclusions: The role of universal hepatitis B appears to be limited in the UK because carriage rates are high in ethnic minorities, with a large proportion of carriers with infection acquired in childhood, prior to their immigration to the United Kingdom.
At risk targeted approach has not worked in London. Due to the difference in the incidence of Hepatitis B in the United Kingdom a "regional approach" in the immunisation policy could be considered, as this did work in Spain in the nineties (in Catalunya).
Social, political and cultural influences on policy and practice need to be taken into account in the implementation of immunisation policies.
Community nursing implications: implementing the existing immunisation strategy to improve the vaccine coverage, identifying risk groups and developing health education activities towards the prevention of this disease, and participating in the development of a multidisciplinary clinical network and a Hepatitis B care-pathway between primary and secondary care.

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