Hep B questions

[KLM99]

The CDC website says that about 1.25 million people in the US have a chronic HBV infection and that it is estimated that 80,000 people, mostly young adults, get infected each year.

It says that a person can get infected:
- by having unprotected sex with an infected person
- by sharing needles when injecting illegal drugs
- by being stuck with a used needle on the job
- during birth when the virus passes from an infected mother to
her baby

And that everyone under age 18 should get it, but also adults who are in the following categories:
- people who have more than one sex partner in 6 months
- men who have sex with other men
- sex contacts of infected people
- people who inject illegal drugs
- health care workers and public safety workers who might be
exposed to infected blood or body fluids
- household contacts of persons with chronic hepatitis B virus
infection
- hemodialysis patients

So I have two questions:

1. If the at-risk adults are only those who are having sex, using drugs, or have potential blood or body fluid contacts in a health care setting, why should all people under 18 get the vaccine?

2. If most of the 80,000 people who are getting Hep B every year are young adults, how are they getting it? Promiscuous sex? Drug use?


Also, in the recent Paul Offit attack of Dr. Sears' Vaccine book, Dr. Offit says:
"Before the hepatitis B vaccine became part of the routine schedule for children, every year 16 000 children <10 years of age were infected with hepatitis B virus after nonsexual, person-to-person contact."

So a third question:

3. If nonsexual, person-to-person contact is such a risk for Hep B, why does the CDC not mention this as a risk factor? What kind of contact is this - just casual contact like sneezing and not washing your hands?

[Sileree]

Originally Posted by KLM99

1. If the at-risk adults are only those who are having sex, using drugs, or have potential blood or body fluid contacts in a health care setting, why should all people under 18 get the vaccine?

Because they couldn't get those at risk to come in and get vaccinated. They think in the long-term it will eliminate the disease and save them money.

“Unlike other infectious diseases for which vaccines have been developed and mandated in the U.S., hepatitis B is not common in childhood and is not highly contagious.

In the United States, most infections occur among adults and adolescents. The recommended strategy for preventing these infections has been the selective vaccination of persons with identified risk factors. However, this strategy has not lowered the incidence of hepatitis B, primarily because vaccinating persons engaged in high-risk behaviors, life-styles, or occupations before they become infected generally has not been feasible.

Efforts to vaccinate persons in the major risk groups have had limited success. For example, programs directed at injecting drug users failed to motivate them to receive three doses of vaccine.

Vaccinating adolescents and adults is substantially more expensive because of the higher vaccine cost and the higher implementation costs of delivering vaccine to target populations. In the long term, universal infant vaccination would eliminate the need for vaccinating adolescents and high-risk adults.”

“Strategy for Eliminating Transmission in the United States Through Universal Childhood Vaccination: Recommendations of the Immunization Practices Advisory Committee.”

[kiara7]

Also, in the recent Paul Offit attack of Dr. Sears' Vaccine book, Dr. Offit says:
"Before the hepatitis B vaccine became part of the routine schedule for children, every year 16 000 children <10 years of age were infected with hepatitis B virus after nonsexual, person-to-person contact."

This is what Dr. Sears says about the 16,000 number:

16,000 kids each year < 10 year old? I went to the MMWR to see the actual reported cases of Hep B in children younger than 10 years of age and found that during the 80s - 90s, prior to Hep B vaccine to infants, there was only 1 case of Hep B per 100,000 children age 0 to 9 in the U.S. With 36,000,000 children in the U.S. in that age range, that only comes out to about 360 cases per year.I can’t believe with such a low number of reported cases that the estimates of 16,000 cases per year can even be close.