Hep B Vaccination at Birth?
Recently, my son’s daycare updated their vaccination records, and we realized that we only had two of his required Hepatitis B vaccinations on record. I had to go to the hospital where he was born and inquire with medical records to see if he received this vaccination at birth. While I thought the HepB vaccination at birth was standard, there is some question about whether our birth hospital actually performed it. We’ll see when the records come in the mail.
We also faced having to switch pediatricians lately due to an insurance change, so I explained the situation to our new pediatrician, a grandfatherly gentleman who was nice enough to sit with us and talk about our son for a length of time defying the normal HMO visit. “I wouldn’t worry about that shot immediately,” he said, “unless your son is planning to get a tattoo soon.”
Among parents who question the standard vaccination schedule, the Hepatitis B vaccine at birth is a frequently discussed topic. I see it pop up often on Mommy chat boards. Most parents don’t really see the urgency of innoculating a newborn against a disease that is primarily transmitted through sexual contact or injection.
Joseph Albietz explains the rationale behind the US HepB vaccination schedule in a November post on Science Based Medicine. This is a concise article that clarifies the public health strategy behind the decision to vaccinate infants at birth. I read the post with great interest, but it was only my recent investigation into my own son’s HepB records that reminded to post the article here today.
To sum it up, vaccinating only a high risk population was a strategy that was tried in the US and then abandoned as not effective enough. Given that the HepB vaccine is incredibly safe, the morbidity and mortality of HepB is substantial, and that the number of cases of HepB has been dramatically reduced using the current strategy–”from 10.7/100,000 in 1983 to 2.1 per 100,000 in 2004. (25,916 total cases down to 6212 cases)”–it makes sense to vaccinate against this disease at birth. There is also the issue that although children make up a small portion of those infected, they tend to become lifelong carriers more often than infected adults.
One of the questions many parents ask (and the question Albietz is responding to in this post) is about the US vaccination strategy verses other countries, specificially those in Northern Europe. Those countries have such a low incidence of the disease that a prevention strategy like that of the US is not cost effective.
Very interesting reading. I hope you will click over and enjoy the entire post.
Charles Said,
January 30, 2010 @ 11:51 pm
Just an FYI,
If mom is Hep B positive, the regular shot they give at birth isn’t enough. You also need hepatitis B immune globulin (HBIG).
Issa Said,
February 1, 2010 @ 11:35 pm
Thanks for this post, the link, and the sum up. I was just recently looking for an explanation for vaccinating at birth on this one, and this gave me the answers I was looking for.
Lesley B. Said,
February 6, 2010 @ 2:32 pm
Our son was born in Ethiopia and when updating his vaccines the public health nurse said that due to his birth country we should do Hep B vaccines early (instead of waiting until he entered school, as was standard in our Province). We have done the first 2 of three shots and will do the third shortly. What I didn’t get is, he lives in Canada now, with the same risk factors as Canadian kids. The 14 months he spent in Ethiopia, if he came into contact with Hep B, vaccinating him now won’t help (and he was tested for that before when he entered the orphanage and was negative). He’s not going to any country with high risk factors for Hep B any time soon. We did it because it was recommended and not a big deal, but I dont’ really understand the logic. I asked the nurse, but I don’t know if she understood what I was asking.
Julie Said,
February 6, 2010 @ 5:14 pm
Lesley, if you read that whole article, it makes more sense. Basically, it’s a practice that is more for public health than for your individual kid. HepB is not uncommon and can have very bad effects. Vaccinating only for at risk individuals didn’t slow the spread of the disease as well as vaccinating all children. So the universal vaccination was adopted to halt the disease. The numbers just made sense.
So even though you and I might think, “Wait, my kid isn’t going to do intravenous drugs any time soon–” there actually is a broader reasoning at work.
An update: it turns out my own son was not vaccinated against HepB at birth! The records from our hospital indicate that they only vaccinated if the mother was positive for HepB at that time. I guess they have now changed the policy and are vaccinating all infants at birth. So we have to catch that third shot now to make sure we’re complete on the vaccination schedule.
Lesley B. Said,
February 11, 2010 @ 8:44 pm
Thanks Julie,
That makes a lot of sense!