I am pregnant with my first child. We are having a homebirth (at least that's the plan so far). So I started researching various topics, considering that with my baby being born at home, he won't be subject to routine shots and interventions, so it is my job to determine which ones to pursue and wich ones not to.
One of those controversial issues is the hep b vaccine. I live in Buenos Aires, Argentina. The routine here is to vaxx for two diseases right after birth: tuberculosis and hep b. Both diseases, according to my research, are almost non existant in this city/country, although they are still administered routinely for herd immunity.
The research indicates that BCG vaccine (tuberculosis) needs to be administered within the first week of birth. It is a one time shot ever in life. I read it needs to be properly administered by competent nurse, otherwise it could carry complications. I didn't find much info on side effects or allergies.
Now, the hep b concerns me a little bit more. I have read some cases of deadly allergies. Plus, the first dose needs to be administered within the first 12 hours of birth, and I do not plan to take my baby outside that soon (if he is born at home, that is).
For a little background, we don't have any known cases of bad reactions to vaccines in my family (everyone is fully vaxxed). Same with allergies (any type, no celiac, no lactose intolerant, nothing). I had rubella when I was 10, went away without complications. My sister (11 years older than me) had pertussis and measles. I have a middle sister who died from measles, when she caught it from my big sister. Back then (the '70s) the measles vaccine was new here and my mom (according to what my dad told me) didn't feel safe to administer it as it was somewhat "experimental". And then my sisters got the desease and one died from it.
So that's my background in a few words.
I could go with the masses and give my newborn the shots. I couldn't find any information of severe side effects of vaccines here in my country. But I know that it happens everywhere in the world.
I am not anti-vaccine, I am more into mindful vaccination, specially after having a sister who died from a VPD. Still, it makes me uneasy to give my brand new baby those shots. It even makes me uneasy to give myself any vaccine being pregnant. I skipped the flu vaccine, but now I am being recommended to take the Tdap vaxx (tetanus, diphteria, pertussis) and I don't know what to do.
One more thing, even if I choose to give my baby the hep b shot, there's still the issue about when to give it to him. It won't be within the first 12 hours of birth. I know I can have a delayed schedule for vaxx, but I have read everywhere that the 1st dose really needs to be administered within those 12 hours.
I take any points of view.
There is no vaccine that 'needs' to be administered within 12 hours of birth, esp HepB unless you, the mother are positive for Hepb. Hepb is not caught thru the air--its mainly a disease of drug users and promiscuous sexual behavior. And no safety studies have been done on pregnant women to determine if vaccination in pregnancy is even a safe thing to do. And i would assume a TB vaccine can be administered at any time in life, not just birth, so no need to rush on a decision for that one.
Adults get the hep B vaccine. It doesn't need to be administered within 12 hours of birth. The 12 hours thing is only if the mother has hepatitis B. If she does, then the baby must be vaccinated right away so that he/she doesn't get it from the birth process. If the mother is not infected, then the child is at very low risk of catching it, until he/she starts having sex or injecting illegal drugs.
The tuberculosis vaccine is not given in the United States because it causes a false positive for the TB PPD test. So that's a very good reason to refuse the vaccine. In the U.S., if someone has a false positive with the TB PPD test, he/she needs to get a chest X-ray, to rule out TB, and a chest xray has a lot of radiation.
I will also say that Hep B is not exclusively transmitted through the mother sex and shooting drugs. It is anyway that blood is present. It lives for a long time outside the human body (unlike HIV for example which dies far more quickly). So sharing toothbrushes, or razors, or earrings can als transmit it (ad are things adolescents often do). I personally choose Hep B vaccine for my son because my husband and I both work with high risk populations and our child visits our offices sometimes and I want him protected.
According to the CDC, there is no maximum time period between vaccine doses (only minimum).
"A vaccine series does not need to be restarted, regardless of the time that has elapsed between doses."
Yeah, what the others said--you can start the Hep B series any time, it doesn't need to be right after birth unless you are positive. Kids are probably at lower risk of getting hepatitis than adults, but if they do get it, they're at much higher risk of it turning into chronic liver illness. And there are ways for kids to get it, ranging from getting molested (God forbid) to getting bit by a positive kid at day care or something dumb like that. We spaced vaccines somewhat and started the Hep B series after she turned 1. She was 2 in June and we just got the last dose at her 2-year checkup. I know in some countries it is not even on the standard schedule but we were fine with getting it.
BCG doesn't last a lifetime though. At least not the ones we got as infants. It is known to be completely worn off around 18-20 years. When I had a TB skin test at age 22, I had no reaction which indiciates that I neither have TB nor antibodies from the vaccine. A friend of mine at age 18 still had a reaction and it was shown to be from the vaccine, not cause she had TB. We all had BCG at age 1 day back then.
A good point, nia82. If this child still lives in an area of high TB prevalence when s/he is older, then the question of whether revaccination is appropriate could be raised at that time. (and, anablis, are you up to date yourself?) I, being in the US, have not had to deal with that particular one. I don't know if it was on the US schedule at one time, but it wasn't when I was born.
Erigeron, I only had BCG vaccine when I was born. I guess I'm not protected anymore.
I know that BCG is administered bc if a child gets TB it could develop into a meningitis, wich could be mortal. Same with the neumococo vaxx. I personally have never met anyone with TB, or heard of any case in my social network whatsoever. But my sister, who is a retired bacteriologist (she switched careers 5 yrs ago) told me that there were a number of TB cases around when she was working at the hospital.
From what I read, TB could seriously affect immunosupressed people and small children. I presume that's the reason why it is just a single-dose vaccine. It is rare that an adult could get it, and if he does, it is not a serious desease. I'll check it out a little more.