Prevention of hepatitis B and C in the European Union and European Economic Area, 2026

Hepatitis B and C virus infections (HBV/HCV) are transmitted through infected blood or bodily fluids and are major causes of chronic liver disease. Although prevention efforts in the European Union/European Economic Area (EU/EEA) have been effective in reducing transmission, the overall burden of chronic hepatitis remains high and continues to drive substantial mortality. This report, using data collected through ECDC’s hepatitis monitoring programme together with data collated from other sources, provides an overview of progress toward the interim targets for elimination for 2025 included in the World Health Organization’s European Regional Action Plan.

Hepatitis B vaccination remains central to prevention efforts, yet progress toward World Health Organization (WHO) targets is variable in EU/EEA countries. Although most countries have universal HBV childhood vaccination programmes, fewer than half are on track to achieve 95% coverage for the three-dose schedule. Access to vaccination for adult groups at high risk of infection, such as healthcare workers, people who inject drugs, men who have sex with men (MSM), and people in prison, varies widely, and data on vaccination uptake in these populations are often incomplete or outdated. Available data on coverage of vaccination among these groups suggest that coverage is suboptimal.

Since ECDC started collecting monitoring data from countries in 2018 there has been continued progress towards the elimination of vertical transmission of HBV, with greater reporting of data and more countries meeting the targets. Three quarters of the countries with data on antenatal screening of pregnant women have met the WHO 2025 target of 90% of pregnant women screened for hepatitis B surface antigen (HBsAg). All five countries providing HBV birth dose vaccination as a universal strategy have met the 90% target for timely vaccination. All countries have national policies for post-exposure prophylaxis, combining birth dose vaccination and hepatitis B immunoglobulin and, among countries with available data, the majority report high coverage among exposed infants. While data availability varies, the overall picture demonstrates substantial regional commitment and strong progress across all countries toward preventing vertical HBV transmission.

Sexual transmission remains a major route of HBV transmission and sex between men is the second most reported route of transmission for HCV, yet specific prevention efforts targeting sexual transmission of hepatitis across different populations have not been systematically monitored across countries. In the face of rising trends in syphilis, gonorrhoea and other sexually transmitted infections reported across the region, this should be addressed in future monitoring efforts.

People who inject drugs continue to bear a disproportionate burden of HCV, underscoring the need for robust harm reduction services, in particular with the injection of stimulant drugs being associated with higher-risk practices and blood-borne virus outbreaks. However, only seven countries meet WHO’s 2025 target for sterile syringe distribution, and 15 meet the coverage target for opioid agonist treatment.

Prevention efforts in healthcare settings also suffer from limited monitoring. While all reporting countries report screening blood for blood-borne diseases, few report data on the use of safety engineered injection devices to measure progress towards the WHO target.

Overall, the EU/EEA is not on track to meet several of the hepatitis prevention targets. While progress has been made in some areas, such as the prevention of vertical transmission, important gaps persist − particularly in vaccination coverage and harm reduction services. These gaps continue to sustain transmission of hepatitis B and C, especially among key populations. Across all domains, incomplete and outdated data significantly limit the ability to assess progress and guide interventions.

Priority actions include:

• Investigating barriers to low vaccination uptake and using these insights to design targeted communication and immunisation strategies in order to increase vaccination coverage.
• Strengthening data systems to better track vaccination coverage among adult key populations to identify gaps in programmes.
• Optimising antenatal HBV screening and post-exposure prophylaxis for infants born to HBsAg-positive mothers, including timely hepatitis B birth dose vaccination to minimise any vertical transmission.
• Expanding harm-reduction services across countries to reach the WHO elimination targets with a particular focus on achieving even higher levels of coverage for clean needles and syringes in countries with high levels of stimulant use.
• Addressing sexual transmission through targeted vaccination and testing interventions in sexual health settings, with an expansion in the collection of data relating to these interventions.
• Improving monitoring systems for hepatitis to generate more complete data for assessing progress is a priority, enabling a more effective targeting of prevention measures.