Hepatitis B: Why Worry, Why Vaccinate?
May 28, 2014
Hepatitis B is a liver infection that is caused by the hepatitis B virus which is spread when blood or other body fluid infected with the hepatitis B virus enters the body of a person who is not infected.
Prevalence of hepatitis B infection
Data from 2009 indicates that an estimated 800,000 to 1.4 million people are living with chronic hepatitis B in the United States alone. With so many people living with this chronic infection, it’s not surprising that approximately 3,000 deaths from chronic liver disease occur each year that are also directly associated with viral hepatitis. While you may believe that you or your family members are at low risk of contracting hepatitis B, the fact is that many people in the U.S. are infected and many people don’t even know they’re infected since they often don’t feel or look sick. In fact, nearly 2 out of 3 people infected with hepatitis B are not aware that they have the virus. Therefore, they don’t take the necessary precautions to prevent the spread of infection to others, including their own children.
Fortunately, 90% of persons who become infected with hepatitis B as adults will clear the infection from the body within 6 months, while the remaining 10% who are unable to clear it will go on to suffer with chronic infection that often leads to inflammation and scarring of the liver. Then, about 15%-25% of those people with chronic infections will go on to develop serious liver conditions such as liver damage, liver failure, or even liver cancer.
Unfortunately, when a baby is infected at birth or during infancy the percentages are reversed. Only 10% clear the infection on their own and the remaining 90% will go on to develop chronic hepatitis B infection. This is why the hepatitis B vaccine is so important for newborns.
Importance of hepatitis B vaccine at birth
We currently have a safe and effective vaccine available that not only prevents hepatitis B infection but can also prevent cancer that comes from chronic infection. The vaccine is given as a series of three shots. The first dose is given between birth and 2 months of age. The second dose is given one to two months after the first dose, and the third dose is given between 6 months and 18 months of age.
Before the hepatitis B vaccine was introduced, about 18,000 children were infected with hepatitis B virus in the U.S. by the time they were 10 years old. Out of these 18,000 children, 50% caught the virus from their mother during birth. Others caught it from either another family member, caregiver or someone else they came in contact with as a child.
Today we take precautions to prevent children from developing chronic hepatitis B infection later in lives by ensuring that they are protected for the diseases as early as possible. The standard in most U.S. hospitals is to administer a birth dose of hepatitis B vaccine to newborn children. Even though mothers are often tested for the presence of the hepatitis B virus, the birth dose is administered to infants regardless of the outcome of this test for a number of different reasons.
Most importantly, if an infant is born to a mother with a hepatitis B infection, than the infection will pass onto the infant. However, one of the most remarkable benefits of the hepatitis B vaccine is that it can actually reverse an infant’s infection status if administered within hours of delivery. Hepatitis B vaccination at birth will prevent transmission of the infection in 70-95% of infants born to chronically infected mothers. Additionally, if the vaccination is combined with hepatitis B immune globulin (HBIG) and administered within 12 hours of birth, the treatment increases to 85-95% effective.
While most babies will be born to mothers who are not currently infected, this “safety net” policy of vaccinating all infants ensures that we’re doing all we can to eliminate infection in all infants – infections that will likely lead to chronic disease later in life. If we only vaccinate children whose mother’s tested positive for the hepatitis B virus, than we will undoubtedly miss the chance to prevent infection when a mothers’ status in incorrectly identified, as a result of errors in maternal testing or failure in reporting of test results. By vaccinating all newborns we ensure babies don’t contract the infection from their mother during delivery, while also providing early protection to those infants and young children who may be exposed by infected persons they encounter during their early years and into adulthood.
How hepatitis B virus in spread and how it is prevented
The hepatitis B virus can be spread through sexual contact, use of contaminated needles, or the improper sterilization of medical, acupuncture, piercing or tattooing equipment – clearly not behaviors that newborn babies engage in. However, we must also consider that it is possible to catch hepatitis B virus through more casual contact, such as sharing wash cloths, toothbrushes or razors. Since most people do not realize they have the virus, it is virtually impossible for transmission to be eliminated and babies can easily contract the virus through casual contact. Young children can also be exposed to other family members as well as other children who don’t even realize they have the virus. Situations at home, in daycare and preschool such as bites, bloody noses, cuts, scrapes and shared use of personal items can expose children to trace amounts of infected blood that can contain enough viral particles to cause infection. The birth dose of vaccine is the most vital way to ensure that every child is protected from infection from the earliest chance of exposure.
Encouraging hepatitis B vaccination
Even though the CDC, ACIP, AAP, AAFP and ACOG, all recommend administering the hepatitis B vaccine at birth, only 70% of infants in the U.S. currently receive the vaccine within 3 days of birth, with state statistics varying from 29% to 88% of infants.
Organizations such as The Immunization Action Coalition (IAC) and the HepB Foundation do their best to support the recommendations through various programs. For instance, the IAC is urging hospitals and birthing centers to meet the national standard of care by recognizes hospitals and birthing centers that have attained 90% or greater coverage rates for administering hepatitis B vaccine at birth through the Hepatitis B Birth Dose Honor Roll.
Since hepatitis B virus is more prevalent than many people realize, why not take every precaution and vaccinate your newborn baby.
For more information regarding the infant dose of hepatitis B vaccine, consider visiting the following resources to find out more:
The Children’s Hospital of Philadelphia’s Vaccine Education Center
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