The Czech Republic: Denmark, Finland, Norway, the Netherlands, Slovakia, Sweden and the UK all have very low HBsAg carrier rates; in the Scandinavian countries, for instance, carrier rates are on the order of 0.05%. Most countries in this group an unconvinced that the carrier rates and the burden of disease caused by new hepatitis infections warrant the expense of universal childhood immunization. In Scandinavia and the UK hepatitis B prevention programmes are based on immunization of high-risk groups. In Scandinavia (excepting Denmark), the UK and the Netherlands, pregnant women are screened and newborns of carrier mothers vaccinated. Only the Czech Republic and Slovakia - both of which now employ high-risk group strategies of hepatitis B prevention - have expressed interest in implementing programmes of universal hepatitis B vaccination of infants and/or adolescents. (C) 1998 Elsevier Science Ltd. All rights reserved.