Van Damme P, Kane M, Meheus A
Centre for the Evaluation of Vaccination, Epidemiology and Community Medicine, University of Antwerp, Belgium.
BMJ. 1997 Apr 5;314(7086):1033-6. doi: 10.1136/bmj.314.7086.1033.
Hepatitis B is a major public health problem even though safe and effective vaccines have been available for over 10 years. Because hepatitis B infection is largely asymptomatic with long term complications occurring after many years it has not received the attention it deserves. Strategies to immunise those at high risk have failed to control the disease. Delegates to the World Health Assembly of the World Health Organisation recommended in May 1992 that all countries should integrate hepatitis B vaccination into their national immunisation programmes by 1997. Some western European countries remain unconvinced that the burden of disease warrants the expense of universal vaccination. However, epidemiological data and economic evaluation show that universal hepatitis B vaccination is cost effective in countries with low endemicity and that it will control hepatitis B, reinforcing the necessity for action.
尽管安全有效的乙肝疫苗已经问世十余年，但乙肝仍是一个重大的公共卫生问题。由于乙肝感染大多没有症状，许多年后才会出现长期并发症，因此它没有得到应有的重视。针对高危人群的免疫策略未能控制住这种疾病。1992年5月，世界卫生组织世界卫生大会的代表们建议，到1997年所有国家都应将乙肝疫苗接种纳入其国家免疫规划。一些西欧国家仍然不相信疾病负担足以证明普及疫苗接种的费用是合理的。然而，流行病学数据和经济评估表明，在低流行率国家普及乙肝疫苗接种具有成本效益，而且这将控制乙肝，这进一步凸显了采取行动的必要性。
