Implementing universal vaccination programmes: Spain.

Until 1990, the immunization policy against hepatitis B in Spain was selective high-risk vaccination. That policy failed to reduce the incidence of hepatitis B and the prevalence rates of chronic carriers. In 1991, Catalonia began a universal immunization programme targeted at 12-year-olds. Six other regions (Castilla-León, Valencia, Extramadura, Navarra, the Balearic Islands and Rioja) introduced vaccination programmes in 1992. In 1993, three more regions (Galicia, Castilla-La-Mancha and Pais Vasco) began immunizing young adolescents. This means that 12-year-olds in Spain are now included in vaccination programmes against hepatitis B.