In recent years there has been increasing interest in immunizing against Hepatitis B. The Center for Disease Control and the American Academy of Pediatrics have recommended universal immunization. Hepatitis B vaccine is now part of the required immunizations for school entry.
WHAT IS HEPATITIS B
Hepatitis B (old serum hepatitis) is caused by a virus passed by blood and other body fluid contamination. It is usually transmitted in much the same fashion as HIV (the AIDS virus) through dirty needles, unsafe sex and from infected mothers to their newborns. It is also transmitted rarely through household or daycare contacts.
Though most people recover from an acute infection, Hepatitis B may cause severe liver damage and death. More commonly it causes chronic liver problems and sometimes, years later, liver cancer. Annually there are about 250,000 new cases of Hepatitis B in the United States and approximately 4,500 people die from Hepatitis B.
RATIONALE FOR UNIVERSAL IMMUNIZATION
The vaccine for Hepatitis B has been around for over tewnty years. Only people at high risk of contact, such as health workers, sexually active teenagers and young adults, babies born to mothers known to have Hepatitis B, and IV drug users were immunized during the first few years. Unfortunately the rate of illness and death from hepatitis B did not fall with this immunization approach largely because at risk people were not getting the full, three shot, immunization series. Because not all women have prenatal care before delivery so they can be tested for hepatitis, and because people frequently engage in high-risk behavior without appropriate precautions, and because hepatitis can rarely be passed in close living situations without high-risk behavior, experts felt the best way to reduce deaths from hepatitis B was to immunize everyone. The vaccine is proven safe, and universal immunization in infants is the recommendation of various expert groups.
IMMUNIZATION SCHEDULE
Immunizations consist of three shots at time zero, one month later and six months later. Immunizations can be started at any age, including in the first hours after birth. Immunizations may be given at the same time other immunizations are given in infancy and childhood. In our office we give hepatitis B in combination with HIB routinely in the infant immunization series.
RECOMMENDATIONS
We suggest that all infants and other children be immunized against Hepatitis B. Immunization immediately is necessary only for people in high-risk situations. These include newborns of mothers infected with Hepatitis B, children living with parents who are carriers of Hepatitis B, people involved with multiple sex partners or shared needle drug use, people travelling abroad where Hepatitis B is common. The general population should have Hepatitis B immunization also through routine immunization programs. We urge all infants and young people to be immunized.
There is no mercury in the HBV.
The official Center for Disease Control handout for HBV is available through the CDC Vaccine Information Statements site. You should review it before getting the HBV vaccine for your child.
Ted Humphry, M.D.
822-2441
this information last updated 8/97