目的比较在乙型肝炎不同流行区接种乙型肝炎疫苗的成本效益，探讨最佳免疫策略。方法采用成本效益分析方法和综合权重评分法，筛选高中低流行区最佳免疫策略。结果隆安、上海和济南三地接种乙型肝炎疫苗均获明显的经济效益；定义的不同流行区均以低剂量免疫策略（１０μｇ×３方案）的效益成本比值最大，高、中、低流行区分别为４９．９１、５４．５３、３７．６８；具有较高免疫保护率的高剂量免疫策略可获最大净效益；权重综合评分分析显示，低剂量免疫策略为最佳乙型肝炎免疫策略。结论建议经济较落后地区实行低剂量免疫策略，期望获得较大效益成本比；经济发达地区实施高剂量免疫策略，以获较大净效益并明显降低人群ＨＢｓＡｇ阳性率 Objective To compare the cost-effectiveness of hepatitis B vaccine in different endemic areas of hepatitis B and to explore the best immunization strategy. Methods The cost-benefit analysis and comprehensive weight scoring method were used to screen the best immunization strategies in high and low endemic areas. Results Longan, Shanghai and Jinan vaccinated with Hepatitis B vaccine showed obvious economic benefits. The defined benefit rates of low-dose immunization (10μg × 3) were the highest among all the endemic areas, 49.91, 54.53 and 37.68 respectively. The highest net benefit was obtained from the high dose immunization strategy with higher immunoprotection rate. The comprehensive weight score analysis showed that low dose immunization strategy was the best hepatitis B immunization strategy. Conclusions It is suggested that the low-dose immunization strategy should be implemented in the economically backward areas and the cost-effectiveness ratio should be expected to be larger. In the economically developed areas, high-dose immunization strategies should be adopted to achieve greater net benefits and significantly reduce the HBsAg positive rate