In the 1970s, Alaska Natives had the highest rate of hepatitis B virus (HBV) infection in the US. Because of this, routine vaccination for all Alaska Native infants beginning at birth was implemented in 1985. Hepatitis B vaccination programs have resulted in significant declines in acute and chronic HBV infections among Alaska Natives, with virtually no new chronic infections observed among the vaccinated cohort. Since 1991, the American Academy of Pediatrics (AAP) and the Advisory Committee on Immunization Practices (ACIP) have recommended hepatitis B vaccination for all infants, preferably beginning at birth. Beginning vaccination during infancy prevents childhood acquisition of HBV, and provides immunity against HBV before individuals reach an age where they may be at increased risk of exposure due to high-risk behaviors (i.e., sexual activity and drug use) or occupation.