Home > Preventable Diseases, Science & Research > Universal HepB Vaccination Provides Long-Term Protection

Universal HepB Vaccination Provides Long-Term Protection

In the past, there has been quite a lot of discussion on this blog regarding the Hepatitis B vaccine that is recommended for infants here in the U.S.  Because of this, I wanted to point out an interesting Reuters Health article I read today regarding a new study that was conducted in Taiwan, a country that has historically battled high rates of Hepatitis B infection.

Unfortunately, Hepatitis B is a viral infection that attacks the liver and spreads by contact with the blood or other bodily fluids of an infected person.  According to the Hepatitis B Foundation, an estimated 350 million people worldwide have the hepatitis B virus and approximately 100,000 new people are infected each year in the United States alone.  In fact, one in twenty people in the U.S. have been exposed to Hepatitis B. 

Since Hepatitis B infection is a prime cause of liver cancer, and the second most common cancer type in Taiwan, the country began mandating immunization for all infants as of 1984.  Interestingly enough, the current research findings reinforce five previous surveys since 1984, that all found lower infections among those born after the mandate.  In 2009, study participants younger than age 25 were far less likely to be infected than those between the ages of 26 and 30 — who were born before universal vaccination.

As detailed in a recent Reuters Health article, the new study funded by the National Taiwan University Hospital, enrolled more than 3,300 participants under 30. Of these subjects, more than 2,900 — born after the mandate — received at least three doses of vaccine in their first year. Approximately 370 subjects, born before 1984, were not universally vaccinated.  After collecting blood samples throughout 2009, the research team found that less than one percent of the universally vaccinated group carried the virus and were infectious to others, compared with 10 percent of those who weren’t universally vaccinated.  The research also suggests that booster doses were unnecessary, since the infection rate did not increase significantly from 1989 to 2009.

Dr. Yen-Hsuan Ni, the study’s lead author from the National Taiwan University in Taipei, told Reuters Health,

“It’s efficacy in young adults is clear.”

In an email he went on to say that 

 “Universal vaccination in infancy provides long-term protection.” 

Unfortunately, the study also found that most cases of vaccine failure were related to the mother’s status since there were 25 subjects who developed an infection despite getting immunized and 86 percent of those had mothers who carried the virus.  Dr. Ni explains that

 “Mother-to-infant transmission remains the key route of vaccine failure that needs to be overcome.” 

As the Reuters Health article explains, the study – published in the Journal of Hepatology – illustrates how countries can benefit from compulsory hepatitis B vaccination for infants.

Another resource which may be helpful to readers is HepB Moms.  Below is just one of their PSAs encouraging parents to get their children vaccinated.

I would presume that the majority of HepB vaccine rejection here in the US probably has more to do with parents thinking that their children are not at risk of contracting the virus than of an issue of vaccine efficacy.  However, the Taiwan research illustrates how recommendations can positively impact a population who has access to this life-saving vaccine.  Additionally, if parents realize the prevalence of the virus, both here in the U.S. and all across the globe, maybe they will understand and appreciate the benefits of universal vaccination.

  1. Sullivan
    June 21, 2012 at 1:43 pm

    Good to see this. There are two prongs to the attacks on the HepB vaccine. (1) it doesn’t confer long term protection and (2) that it is a disease transmitted by drug use or sexual contact so why give it to infants?

    this story addresses point (1)

    There are other methods of transmission and young children are infected. And it is much worse the younger one is when infected.

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  2. Lara Lohne
    June 21, 2012 at 1:56 pm

    I remember reading a comment on IR a few years ago from a mother who had a child that contracted hep B and the struggles she has to ensure that her child remains healthy as well as preventing the transmission of the virus to other little children her child may come into contact with. One of the best ways to ensure a lack of transmission is for the other children to be vaccinated against hep B. With the rise in rates of vaccine refusal, this places great concern on this mother, because she doesn’t have any way of knowing if a child her child may come into contact with is vaccinated or not. I don’t recall how her child became infected, but I don’t believe it was from her. If I recall, she was hep B negative and continued to test negative years after her child’s birth. Since a parent is protected from revealing hep B status of their child, there really isn’t any way of knowing if a child is infected, a carrier or not. The best way to ensure your child is safe, is not quarantine, like many vaccine refusers would suggest (children who don’t interact with their peers are not going to be able to develop properly and will also be extremely lonely). The best way to ensure your child is safe, is to get timely vaccines.

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  3. lilady
    June 22, 2012 at 4:37 am

    I am reposting my own post from June 21, 2012 about the Universal Dose Vaccine Hepatitis B Vaccine Recommendation that is the policy of the CDC and the WHO:

    @ Amanda: The risk of transmission of the hepatitis B virus through “vertical transmission” (mother to infant before birth or during labor) are huge. And when a newborn is infected (it is a blood-borne transmissible virus), the chances of that infant to stay infected for life are estimated by epidemiologist to vary from 40% – 90 %. The higher 90 % lifelong infection rate for newborns are based on the number of viral particles contained in the mothers bloodstream….marked by the presence of the hepatitis B “e” that indicates high potential infectivity.

    Newborns have immature immune systems and are unable to clear the virus. (An otherwise healthy adult’s risk for lifelong carrier status after exposure and contracting the virus is ~ 5 %).

    With the development of accurate blood tests and effective post-exposure prophylaxis (the first hepatitis B vaccine AND special immune globulin), administered to a newborn within 12 hours of birth, the rate of neonatal hepatitis B infections has plummeted.

    Not all household members submit themselves to testing for the presence of the virus…and not all caregivers are tested, which puts an unimmunized infant at risk for “horizontal transmission” , hence the recommendation to begin the hepatitis B series, with the first immunization, before the infant leaves the birthing facility.

    That birth dose recommendation is in place in just about every country, in accordance with the WHO recommendations. Here’s a CDC website for you to peruse…that will provide you with accurate information about the hepatitis B vaccine and its use to prevent transmission of the virus to newborns and young children:

    http://www.cdc.gov/hepatitis/HBV/PerinatalXmtn.htm

    If you have a questions why these recommendation are in place, or need any clarification, please pose those questions and concerns here. I was the Perinatal Hepatitis B Prevention Program nurse-coordinator within a large suburban county, just before my recent retirement from public health.

    I find that study from Taiwan quite different from every other study I’ve read about the long term study of children and adults who are identified as having risks factors (infants exposed to the hepatitis b carrier mothers, health care workers, sexual partners of know carriers). If an infant starts the three dose series within 12 hours of birth and receives HBIG within that 12 hour window, then completes the three dose series in a timely fashion…and within a short period of time after completing the series is tested for immunity (positive hepatitis B surface antigen)…then the child has little or no chance of acquiring the virus.

    Children who do not have the immunity, need to be immunized and then tested again for immunity. Few, if any children, do not become immune after completing the second series of vaccines. Children as a group, immunize quicker with higher titers, that adults who are given the 3-dose hepatitis B series.

    Studies done have tested children and adults who were immunized for the past thirty years and the results of those studies indicate immunity…most probably lifelong.

    If a person is know to have aquired the surface antibody, indicating immunity and then is tested a few years later and appears to have “lost” their immunity against the virus, the recommendation are to NOT reimmunize that person. Exposure to the actual virus triggers an anamnastic response in the body…it boost the immunity to the virus and brings the patient into a high IGG immune status.

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  4. ella
    June 22, 2012 at 1:05 pm

    Before allowing their child to get the hep-B vaccine (often given at the hospital when they are born without asking permission), all parents should read Judy Converse’s book When Your Doctor is Wrong: Autism and the Hepatitis-B Vaccine. Her son reacted to this vaccine given without permission when he was born, with days of endless shrieking, vaccine-induced encephalitis, and severe explosive diarrhea. He was later diagnosed with autism. She was invited to recount her compelling experience at the sub-congressional safety hearing on this extremely dangerous vaccine in May 1999, which found that the vaccine was indeed very dangerous, and said it absolutely should not be given with mercury. But hospitals across the country continued to give it with mercury for several more years, causing encephalitis and autism in my goddaughter. Converse writes several chapters with statistics on this disease and vaccine, bearing out her statement that this vaccine causes more adverse events (including death, as in Michael Belkin’s daughter) than all other vaccines combined.
    Children born to uninfected mothers do not get this disease. It is not spread casually among children. It is spread like AIDS, through unprotected sex and dirty needles. Dr. Sears researched it, and said that before the vaccine started to be given to newborns in 1991, an average of only 360 children a year were getting the disease, most or all born to infected mothers. Researchers artificially jacked this number up to 30,000 a year just to get the ball rolling on giving this vaccine to every newborn in America. Anyone notice that the autism epidemic really took off at that time?
    Hepatitis B, when it occurs, is usually subclinical. In those in whom it is worse, it causes symptoms like those of severe flu, often for months or even years. Most of these people eventually recover with permanent immunity. A tiny minority of this number progress to severe liver disease or cancer, and usually die from it. This minority usually has impaired health from their alcoholism or drug addictions.
    The vaccine has caused many cases of multiple sclerosis, being taken off the mandatory vaccine schedule in France about fifteen years ago after having caused so much MS in recently vaccinated people.
    All adults should be free to choose to get this vaccine if they think their risk of exposure warrants it, or free to decline it if they fear the considerable risks of the vaccine more than the disease. It is extremely unwise to give it to babies or children, except those born to infected mothers. Parents should certainly research it very carefully before permitting it to be given. Many hospitals get a monetary bonus for giving it to newborns before they leave the hospital, so babies born at the hospital should be kept at the mother’s side at all times if the mother does not wish to permit this vaccine. Judy Converse didn’t know for months that it had been given to her baby at the hospital without asking permission. My friend was only informed after the vaccine was given, although it said in her baby’s records that it had been given with consent, though there was no consent form in the records.

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  5. Lara Lohne
    June 22, 2012 at 1:12 pm

    Vaccines do not cause autism. Anecdotal stories are not scientific evidence, nor are they enough to refute that science has been unable, after dozens of studies for over a decade, to find any causal link between vaccines and autism. Please stop spreading your misinformation because it is not correct, and most of these ‘vaccine reactions’ told in these stories are assessments made by the parent without any medical expert to validate their claim. Sorry, I’m not unintelligent, but I also know I don’t know everything, therefore I am not even going to try and diagnose something in a newborn if I don’t have the medical education and experience to actually know. I didn’t even self diagnose my son with autism, even though it was the only thing that it could have been and everything I read pointed in that direction, I waited for the experts to tell me that was what it was. That way, I had the diagnosis and I also have that missing link to be able to move forward with approved and proven therapies to help him. Funny, even though my son was the only one of my 6 children that did not get vaccinated on schedule, he’s the only one who developed autism. How would you account for that if it’s all in the vaccines? Granted my story is only an anecdote, but the difference between mine and yours is mine has science behind it.

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  6. Sullivan
    June 22, 2012 at 1:18 pm

    “When your doctor is wrong”…does that book apply to Dr. Sears as well?

    “It is spread like AIDS, through unprotected sex and dirty needles.”

    But not *only* this way. This is how a simple statement can mislead people.

    ” Dr. Sears researched it, and said that before the vaccine started to be given to newborns in 1991, an average of only 360 children a year were getting the disease, most or all born to infected mothers. ”

    The prevalence of anti-HBc ( hepatitis B core antigen, a sign of previous infection) has dropped by a factor of 3 in young people since the introduction of the vaccine:

    Age 6-19: decrease from 1.9% in 1988-1994 to 0.6% in 1999-2006 (P < 0.01);

    Source: http://www.hivandhepatitis.com/hep_b/news/2010/0702_2010_a.html

    This indicates that the program is working. Further, a prevalence of 2% in young people is much higher than 360 children per year.

    Dr. Sears is not a researcher, correct? So, by "research" you mean he read somewhere that those were the facts? Did he say where he got his "facts"?

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  7. Chris
    June 22, 2012 at 2:57 pm

    ella:

    Judy Converse’s book When Your Doctor is Wrong: Autism and the Hepatitis-B Vaccine.

    1: She is a nutritionist and not an epidemiologist. She does not have the relevant background.

    2: Yazbak is involved with that book. He and Buttram helped keep a man who shook his girlfriend’s baby to death out of jail by blaming vaccines, when the child had obvious fractures. I will never take the word of anyone who defends those who murder children.

    And, while it is very sad that Mr. Belkin’s daughter died of SIDS, he should release the full medical records if he really wants us to believe it was the vaccine. Until, then, we will stick to the science and not anecdotes.

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  8. Kelly
    June 22, 2012 at 6:21 pm

    The vaccine has caused many cases of multiple sclerosis, being taken off the mandatory vaccine schedule in France about fifteen years ago after having caused so much MS in recently vaccinated people.

    This is also a false statement. HepB vaccine does not cause MS.

    http://www.cdc.gov/vaccinesafety/Vaccines/multiplesclerosis_and_hep_b.html
    http://www.immunizationinfo.org/issues/vaccine-safety/hepatitis-b-vaccine-and-multiple-sclerosis

    France also vaccinates for HepB using a hexavalent vaccine at 2, 4, 16 – 18 months. You can confirm this information by selecting France from the country list at this site : h_ttp://apps.who.int/immunization_monitoring/en/globalsummary/scheduleselect.cfm

    ella, please check your facts before posting such blatant misinformation.

    Like

  9. lilady
    June 22, 2012 at 7:58 pm

    OMG, is Ella really using Dr. Sears as a resource? This is the same virulent anti-vaccine doctor who comes up with an alternate vaccine schedule…based on none of his research (he readily admits that his *advice* is based on nebulous concerns about *too many, too soon* and his prejudices against adjuvants and excipients used in vaccines. He doesn’t know any of the science (chemistry, immunology…and certainly NOT epidemiology of vaccine-preventable diseases).

    Here, for Ella, is some information for health care providers…although she simply doesn’t understand educational materials that are geared to parents:

    http://www.cdc.gov/hepatitis/HBV/HBVfaq.htm

    Listen up Ella: I was the Perinatal Hepatitis B Prevention Program nurse-coordinator in a Public Health Department with a catchment area of 1.2 million residents including a large foreign-borne population and including women born in areas of the Chinese Mainland where the rate of chronic Hepatitis B carriage exceeds 10 %.

    Long before the Universal Hepatitis B Birth Dose Recommendations made by the the CDC and the WHO, staff assigned to the Prevention Program were notified about pregnant women’s chronic Hepatitis B infections. (Their blood tests showed positive hepatitis B surface antigen…many also had positive “e” antigens…showing high viral loads…as well.)

    Staff did intensive case management and the “cases” were open for at least 18 months…sometimes longer…from the first trimester…through the birth…through the first immunization and HBIG given within 12 hours of birth…through the completion of the 3-dose series, and…through testing of the infant between 6-12 months of age, to make certain the infant was immune.

    When I retired from public health seven years ago…that one program had provided case management for more than 900 pregnancies and only 3 of the nine hundred babies tested positive for the virus; a remarkable record when you consider that up to 90 % of infants exposed to the virus at birth who are not provided prophylaxis become infected..and for most of them, remain infected for the rest of the lives.

    Read the link I provided you. Tell us why the nature of this chronic disease has great risk for infants…and adults…who are not diagnosed…in terms of morbidity and mortality.

    Like

  10. Nathan
  11. lilady
    June 22, 2012 at 11:08 pm

    @ Nathan: She reads mighty suspicious…same old, same old, tired and repetitive stories.

    If Ella isn’t CIA…then they dropped out of the same high school.

    Like

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