Adolescent hepatitis B immunisation - should it be the law?

Universal hepatitis B immunisation of young adolescents was included in the Australian Standard Vaccination Schedule in 1998. However, rates of immuni sation among adolescents world-wide have often been inadequate. Australia's experience in this area is no exception, particularly in States where scho ol-based delivery is not carried out. Legislation for preschool immunisation certification currently exists in se veral States and this legislation is distinctly different from the compulso ry or mandatory immunisation that exists in several other developed countri es. There have been demonstrable gains in uptake as a result of mandatory i mmunisation requirements in the United States and there is evidence to sugg est that immunisation certification in Australia has also been beneficial. However, it is important to recognise that both certification and mandatory immunisation legislation have inherent difficulties. In this paper, we argue that legislation for high school immunisation certi fication, as part of a multi-faceted vaccine delivery strategy tailored to adolescents. is required to achieve the uptake that will lead to interrupti on of transmission of the hepatitis B virus in Australia. Not only will it substantially reduce incident cases of hepatitis B for the next decade, it will also provide a framework for the successful introduct ion of future adolescent vaccine initiatives in Australia.