More than 90 countries have now included hepatitis B (HB) immunization into their National Immunization Programmes as a routine vaccine given to all infants and/or adolescents and many additional countries are planning for the introduction in the next two years. These countries include all industrial countries except the United Kingdom, Ireland, The Netherlands, the Scandinavian countries and Japan. Countries with routine HB immunization include about 45% of surviving new-borns, but almost 70% of hepatitis B virus carriers live in countries with routine HB programmes. Population based studies of HB immunization from around the world are now being reported with as long as 10 to 15 years of follow-up, showing a reduction of the chronic HB carrier prevalence from high (8% or greater) to low (less than 2%) endemicity in immunized cohorts of infants. Reductions in the price of HB vaccines, a significant increase in the number of producers and the advent of combination vaccines including an HB component will make the vaccine available to more children world-wide, but economic constraints continue to hamper introduction of this vaccine to the children in the poorest countries.