Kids first?

Nearly 20 years afer the licensure of a vaccine against the hepatitis B virus, an estimated 300,000 U.S. residents still become infected with the potentially fatal liver virus every year. One major reason for the persistence of hepatitis B is that few adolescents and adults whose sexual and drug-using behavior places them in danger of infection are able to obtain the vaccine. Public health authorities and legislators have spent hundreds of millions of dollars to vaccinate low-risk but politically popular babies, while largely ignoring high-risk older siblings, parents, aunts, and uncles. Now this strategy, chosen in part for political reasons, is unwittingly fueling anti-vaccine efforts. The United States' poor use of the hepatitis B vaccine will surely cast a shadow over efforts to prevent HIV, a disease with remarkably similar transmission patterns.