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To determine the incidence of hepatitis B and possible trends since the introduction of the hepatitis B vaccine in the Netherlands, serologic and epidemiologic data pertaining to risk factors of disease acquisition were obtained. Recent studies from the United States showed that the current strategy for prevention of hepatitis B, which targets high-risk groups immunization, has failed to have a significant impact on the incidence of disease. This finding made reconsideration of the similar strategy for prevention of hepatitis B in the Netherlands necessary. Since the major means by which the status of infectious diseases are monitored in the Netherlands are limited the need for a more active surveillance system in order to accurately reflect the success of prevention, is stressed.