Why is the Hep B vaccine given to newborns? Considering opting out.

[spargel]

I'm having a hard time understanding why the Hep B vaccine is given to newborns. I wasn't vaccinated until I was 31 and only then, because I was working a job in a remote location where getting the disease was a real possibility. Several months later I was diagnosed with multiple sclerosis. I've since read research that indicates a correlation between the Hep B shot and getting MS (the theory is that this particular vaccine may turn on the genes that are responsible for making MS active - so I had the genes, and the shot turned it on). I'll never know if this is why I got it (I have a brother and a mother with MS too - so I know I'm genetically susceptible) I'm very hesitant to allow my child (let alone, my newborn!) have this shot in particular since there is a good chance that they will inherit my genetic susceptibility to MS. I'm also wondering if this is one that schools tend to require prior to admittance admittance?

[littlecityfarmer]

My understanding is that Hep B vax is given to hospital-born newborns before discharge because that's when doc's have the most access to them. Not for a medical reason, just for the convenience of having a "captive" audience. Babies, other than those born to Hep B-infected moms, generally aren't at risk for Hep B unless they are sharing dirty needles, having unprotected sex with infected partners, or otherwise exposed to body fluids from an infected person. 

[Kyamo]

In Ontario, the standard schedule is for Hep B to be done in grade 7.  It is not given to newborns here.  

[womenswisdom]

Originally Posted by littlecityfarmer 

My understanding is that Hep B vax is given to hospital-born newborns before discharge because that's when doc's have the most access to them. Not for a medical reason, just for the convenience of having a "captive" audience. Babies, other than those born to Hep B-infected moms, generally aren't at risk for Hep B unless they are sharing dirty needles, having unprotected sex with infected partners, or otherwise exposed to body fluids from an infected person. 

Yep, that's it.  Basically it's a public health policy designed to 1. Vaccinate any babies born to mothers who are Hep B positive and 2. Start the vaccine series at a time when over 95% of the population will be in a known place (in the hospital at birth).  You can certainly decline it and I believe the CDC recs are at birth or at the 1 week ped visit, so you could just tell the hospital you plan to have it done "later" and that should be acceptable.

[Evergreen]

Their reasoning is that since 1/3 of all people infected with Hep B actually have no risk factors and infants infected are particularly at risk for developing chronic Hep infection (about 90 percent chance) they want to make sure it is done as early as possible - aparently it's pretty effective if given within 12 hours of birth.  Personally, I think that if the parents have been tested and are negative there is no reason to give it this early. I have chosen not to give it to any of my children.  I would if we were going to be traveling to an area with high rate of infection and I will give them the option of getting it when they are in middle school.

[Turquesa]

Originally Posted by spargel 

 I'm also wondering if this is one that schools tend to require prior to admittance admittance?

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I have no clue what the answer would be in Italy.  In the U.S., it varies by state.  My state, which is pretty liberal about vaccination exemptions, (i.e. we have philosophical exemptions here) "requires" it for school entry.

[kilamonster]

Originally Posted by littlecityfarmer 

My understanding is that Hep B vax is given to hospital-born newborns before discharge because that's when doc's have the most access to them. Not for a medical reason, just for the convenience of having a "captive" audience. Babies, other than those born to Hep B-infected moms, generally aren't at risk for Hep B unless they are sharing dirty needles, having unprotected sex with infected partners, or otherwise exposed to body fluids from an infected person. 

This is what I have read as well.  DS is almost 3 and he hasn't had that series.

[carriebft]

-trying to get vaccine numbers up

-avoiding the riskiest time to be infected (as PP said, infection as infant is more likely to become chronic)

-daycare and schools have been a source of transmission of Hep B- a small one but present- (because, contrary to popular belief, it can be spread in ways other than needles and sex)- again, leading to younger children with cases which is more dangerous.

I guess when you think of horizontal transmission to chidlren, you think of how a family is together in the same house for so long during a day, day in and day out. this can be the same situation at a daycare, thus leading to the transmission risk.

-attempting to stop mother to infant infection

Edited by carriebft - 11/19/10 at 6:44am

[carriebft]

I would add that transmission in a day care setting is greatly reduced in the USA since you have that kind of "herd immunity" affect in that there are less carriers and less people to keep a chain of transmission going. Other places don't have this:

http://www.ncbi.nlm.nih.gov/pubmed/11402989

http://onlinelibrary.wiley.com/doi/10.1002/jmv.10242/abstract

couple of school based stories found here- mostly outside the USA- wrestling team in Japanese school, daycare in Sydney, football team in Japan, etc.

http://docs.google.com/viewer?a=v&q=cache:7uM_wqvpgI0J:www.immunize.org/catg.d/p2100nrs.pdf+hepatitis+B+outbreak+daycare+school&hl=en&gl=us&pid=bl&srcid=ADGEEShdhA641dLuM8oO4GTUbmPgpRFQy_7WmX6FW3GDbVcbi5qAUnd4-3VlfnYluhQYJV5WuyDuzTFv768wPsXAoQQDFdEEvUVs8O45EgKA_33fXMBzTeJpo47xo-Izmj_rUpEErPiU&sig=AHIEtbT0c2XpmuI0x0F7ypEJzHXdxUEmpw 

[AFWife]

I was told that it's done like that because they don't always know the status of the mom coming in...I guess due to moms with no insurance just coming in to birth? So, they assume that everyone is infected to cover their bases...

[ammiga]

No state has required vaccines for school entry. You can fill out an exemption and turn it in instead.

[HRJ]

My ped does not recommend it.  She recommends people refuse it.  Dr Sears sees no point in it (if mom is healthy) until the child is at the age where they could be having sex or doing drugs.  Two of the three Hep B shots have mercury in it.  And my ped has info on links to autism and Hep B. 

[CherryBomb]

Originally Posted by Evergreen 

Their reasoning is that since 1/3 of all people infected with Hep B actually have no risk factors and infants infected are particularly at risk for developing chronic Hep infection (about 90 percent chance) they want to make sure it is done as early as possible - aparently it's pretty effective if given within 12 hours of birth.

This is the explanation I've always heard.  We skip it at birth and have it done with the other shots at 2 months. 

[Emmeline II]

The reasons are:

1. Who knows what mom has been doing between the initial blood work and delivery.
2. Get'em before they become drug-using promiscuous teens.
3. It is easier to convince the manufacturers to produce or to keep producing a vaccine that is on the CDC vaccine schedule.

[smeep]

I would decline it. Honestly, I didn't even KNOW that it was traditionally given at birth until I took DS to his first pedi appointment at 2 months... If I remember correctly, it went something along the lines of...

Me: "We won't be vaccinating."

Pedi: "What?"

Me: "I'm pretty sure I won't be vaccinating him at all, but I'm not 100% sure yet so I'll be declining all vaccines this time."

Pedi: "Didn't you get the Hep B shot at the hospital?"

Me: "My midwife didn't offer it. I didn't even know it was given to newborns."

Pedi: "You at least got the Vitamin K shot, right?"

Me: "No, I declined it."

Pedi: "What?! Don't you know he could DIE from hemorrhage?!"

Me: "I've done my research, he had no risk factors and the shot isn't exactly harmless itself so I declined it."

....I went to her because I was told she was "okay" with no-vax. But by okay I guess that meant she wouldn't "fire" me and gave me your typical stupid BS "fact" sheets that don't list death for any of the vax's but list death for half the diseases and wanted me to sign the "bad mom" waiver. I think I saw her once more after that which is when she recommended cereal at 4 months. I never saw her again.

Oh, and my midwife only attends births at her center or the client's home. She is a CNM, but she is pretty crunchy. She didn't offer the Hep B and she gave me info on the Vit K so I could research it myself. I later researched Hep B after that pedi appointment and, let's just say, I have NO plans to ever vaccinate a child of mine against Hep B. The risks of the disease certainly come nowhere near weighing out the risks of the vaccine for DS or this upcoming baby.

[caned & able]

Originally Posted by Emmeline II 

The reasons are:

1. Who knows what mom has been doing between the initial blood work and delivery.
2. Get'em before they become drug-using promiscuous teens.
3. It is easier to convince the manufacturers to produce or to keep producing a vaccine that is on the CDC vaccine schedule.

RE:  the bolded part -

The immune effects of the vaccine wear off before the children become adolescents, - i.e., drug-using and promiscuous - and the second vaccine is given at ages 11-13, so again, the question is asked, "Why at birth?"  My cousin has juvenile rheumatiod arthritis from this vaccine and will never have a normal, painfree life. She would rather have Hepatitis B.

[spargel]

Thanks so much for the input. That settles it, we won't be vaccinating for Hep B. I've already been vax'd for it, I'm pretty sure my DH has too, I can get titres just to make sure. It won't be in daycare, so the risks there are lower too. I suspected it might be a whole lot of hype and it appears that this one may remain completely unnecessary throughout life.