CDC link on rationale for Hep B vax for infants

[MamaMunchkin]

Found this link recently and would like to share - as said in title, it discusses the rationale behind Hep B immunization for infants.

http://www.cdc.gov/mmwr/preview/mmwrhtml/00033405.htm

[Rrrrrachel]

Thanks for posting this, mama.  I meet so many people who misunderstand the hep B vaccine.  Hep B is a real risk for children, there are thousands of cases a year of children under 10 contracting it, about half are NOT from their mothers, and children are far far more likely to develop a chronic lifelong case than adults, they are also at greater risk for liver cancer.  Even among adults there are a lot of cases among people who do not have particular risk factors (drug use, promiscuous sex)  Child to child transmission happens often enough that it's not "just" a STD, and I dont' think people realize that when they decide to wait until their child is older since their toddler isn't sharing needles.

[Rrrrrachel]

http://www.chop.edu/service/vaccine-education-center/a-look-at-each-vaccine/hepatitis-b-vaccine.html

Quote:

Before the hepatitis B vaccine, every year in the United States about 18,000 children were infected with hepatitis B virus by the time they were 10 years old. This statistic is especially important because people are much more likely to develop liver cancer or cirrhosis if they are infected early in life, rather than later in life (most people are infected with hepatitis B virus when they are adolescents and young adults).

About 9,000 of the 18,000 children infected in the first 10 years of life caught the virus from their mother during birth. However, many young children didn't catch the disease from their mother. They caught it from either another family member or someone else who came in contact with the child. Because hepatitis B can be transmitted by casual contact, and because many people who are infected with hepatitis B virus don't know that they have it, it is virtually impossible to be "careful enough" to avoid this infection

The birth dose of Hep B is the only real chance we have of protecting children from catching hep b from their mothers at birth.  If that dose isn't given in the first twelve hours that chance ot protect the child is gone.  I felt comfortable skipping the birth dose because I know my hep B status, but many people who have hep B have no idea.  That's why the birth dose is public policy.

[nia82]

But every mother in the US is tested for HepB in pregnancy. I don't know how anyone can get out of the test? You get routinely tested for HepB/C, HIV, chlamydia, gonorrhea in pregnancy. Especially if you want a waterbirth (then it's absolutely necessary or they won't let you waterbirth).

Instead of making a one size fits all mentality, it is much better to focus on risks groups and deliver special programs to risk groups.

[Rrrrrachel]

Not every woman in the us even receives prenatal care, let alone getting tested for all those things.

[Rrrrrachel]

And if you read the link in the original approach it explains how they tried the risk group approach and it wasn't effective.

[Super~Single~Mama]

Also, Rachel didn't say that it is irresponsible of someone who knows their Hep B status at the time of giving birth to decline the vax. Quite the opposite. My ds did not receive Hep B at birth because it was not offered at the birthing center where I delivered, but I was tested and had it been positive I may have been risked out.

[Mirzam]

Originally Posted by Rrrrrachel 

Not every woman in the us even receives prenatal care, let alone getting tested for all those things.

83% of women received timely prenatal care, that is first trimester care, in 2001, obviously that was 11 years ago, but it is probably not hugely different now. So that is a good majority of women that know their HepB status.

[Rrrrrachel]

And can very easily opt out of the birth dose of hep b.

[amnesiac]

In my state, women are not only tested prenatally but also at the time of delivery.

Originally Posted by Rrrrrachel 

http://www.chop.edu/service/vaccine-education-center/a-look-at-each-vaccine/hepatitis-b-vaccine.html

The birth dose of Hep B is the only real chance we have of protecting children from catching hep b from their mothers at birth.  If that dose isn't given in the first twelve hours that chance ot protect the child is gone.  I felt comfortable skipping the birth dose because I know my hep B status, but many people who have hep B have no idea.  That's why the birth dose is public policy.

I'm interested in understanding the context of those CHOP stats regarding pediatric transmission. I do also find it interesting that their statement regarding casual contact as a source of transmission is misleading & contrary to the CDC's position that casual contact is not problematic. They seem to imply that half of pre-vaccine era infections in children <10 years old are acquired from casual contact. While prolonged, close personal contact (such as household contacts might have) is indeed a risk factor, I find that their statement might mislead some people into thinking that casual social contact is a big risk for infection. I find misleading people using scare tactics to be a turn-off.

[Rrrrrachel]

That's great that they test at the time of delivery! I didn't realize the turnaround was that fast but that's awesome. I'm not sure what you mean by the context of the chop stats. I have read that hep ban be spreads by sharing tooth brushes or razors as well as if children bite each other. So I guess it depends on how you define casual contact.

[Taximom5]

Originally Posted by Rrrrrachel 

And can very easily opt out of the birth dose of hep b.

For many of us, it's very difficult to opt out of the birth dose of Hep B.

My child was given Hep B without my permission and against the written instructions in his chart.

And these parents had their newborn taken from them because they refused the hep B shot, even though there was no medical indication for the shot: http://www.thehealthyhomeeconomist.com/mother-who-questions-vax-at-hospital-has-newborn-taken-away/

[Rrrrrachel]

Those are a handful of extreme and not typical examples.

[Mirzam]

Originally Posted by Taximom5 

Originally Posted by Rrrrrachel 

And can very easily opt out of the birth dose of hep b.

For many of us, it's very difficult to opt out of the birth dose of Hep B.

My child was given Hep B without my permission and against the written instructions in his chart.

And these parents had their newborn taken from them because they refused the hep B shot, even though there was no medical indication for the shot: http://www.thehealthyhomeeconomist.com/mother-who-questions-vax-at-hospital-has-newborn-taken-away/

Mine was given it without my permission also, they didn't even discuss it with me, they just did it. Same with the BCG. This was 22 years ago in Hong Kong. I wasn't very savvy all those years ago though unfortunately.

[Taximom5]

Originally Posted by Rrrrrachel 

Those are a handful of extreme and not typical examples.

I doubt that you are an expert on what is typical hospital policy.

[Mirzam]

Originally Posted by Rrrrrachel 

Those are a handful of extreme and not typical examples.

So that makes it okay?

[Rrrrrachel]

No, it doesn't make it ok, but it doesn't change the fact that moms can decline hep b at birth.

I feel pretty confident that vaccinating children against their parents will is not hospital policy.

[Adaline'sMama]

Thanks for posting this CDC link. I was under some false impressions, and I realize now that I need to take a better look at how many actual infant cases there are that are not passed from the mother.

Originally Posted by Taximom5 

For many of us, it's very difficult to opt out of the birth dose of Hep B.
My child was given Hep B without my permission and against the written instructions in his chart.
And these parents had their newborn taken from them because they refused the hep B shot, even though there was no medical indication for the shot: http://www.thehealthyhomeeconomist.com/mother-who-questions-vax-at-hospital-has-newborn-taken-away/

I've seen this link posted several times, and while I think it's awful that the parents had to go through that, but I do think that it's a pretty uncommon experience. I live in rural Kentucky and have had no problems saying "nope" to any and all newborn medical interventions. Also, we havent had a problem not leaving the babies side. I think it's pretty common for parents to remain with their babies at all times now a days. I know there are reasons that mothers and fathers get separated from their children at birth, but most people dont. Most people have no reason to ever have a nurse handling their baby, let alone to be away from them long enough for them to get shots. Most people are not getting their babies taken away because they declined a vaccine, in fact, this is the only recent instance Ive heard of.

*also, having your baby taken into state custody for less than 24 hours is hardly "any parents worst nightmare".

[Bokonon]

Originally Posted by Adaline'sMama 

Thanks for posting this CDC link. I was under some false impressions, and I realize now that I need to take a better look at how many actual infant cases there are that are not passed from the mother.
I've seen this link posted several times, and while I think it's awful that the parents had to go through that, but I do think that it's a pretty uncommon experience. I live in rural Kentucky and have had no problems saying "nope" to any and all newborn medical interventions. Also, we havent had a problem not leaving the babies side. I think it's pretty common for parents to remain with their babies at all times now a days. I know there are reasons that mothers and fathers get separated from their children at birth, but most people dont. Most people have no reason to ever have a nurse handling their baby, let alone to be away from them long enough for them to get shots. 

1 in 8 babies is born prematurely - that's a lot of infants who may have to be in the NICU.  Yes, it's probably common for a full-term, healthy baby to be able to stay with mom, but many babies don't, and we've all read stories about babies given formula or circ'ed without parents' permission, so it shouldn't be surprising that some babies are also vaccinated without parents' permission.

I'm not saying it's common, but it happens.

[Adaline'sMama]

Are babies really vaxed in the nicu? My doc wont even vax with a cold, it seems silly to vax with a child who is in the nicu.