Hepatitis B vaccine has been used for over 10 years. It is efficient and safe. Protection of risk groups against hepatitis B virus infection is now achieved and vaccination of newborns and adolescents is a main public health problem. Bad responders are well characterized and immunomodulatory interventions (cytokines) must be tested in these patients. Response to hepatitis B vaccine is genetically determined and the possibility of vaccine induced escape mutants should lead to careful epidemiological studies of the spread of hepatitis B virus infection.