Tell me about Hepatitis B vaccine - pros and cons...

DH and I need to decide about Hepatitis B pretty soon (I know they like to do it in the hospital, but it is not *required* for discharge from the hospital here) - so far we are not convinced that we want DD to get it - the reason I keep hearing "its just part of the schedule now" doesn't cut it. It seems that the immunity wears off after 15 years according to the brochures we've gotten, and isn't that about when they would be getting to a risky time anyway? No flames please, but it kind of seems like a vaccination to prevent STDs and lower the risk from IV drug use, which raises all sorts of other issues. DD will not be working in the medical field in the next 15 years and handling blood, so I guess I'm confused why it's so highly recommended. Am I misreading the info? What have you all done? TIA for any advice!

Allison
EDD 10-30-05 It's a girl!
http://lilypie.com/days/051030/0/25/1/-8/.png

You don't have to start it before DD goes home from the hospital, but most (all?) schools require it to start kindergarden now. My rational in getting it done earlier rather than later is that I can't control what playmates of my kids might have contacted at some point in their lives, and playgroups, day care and preschool are not allowed to discuss other students health issues. Therefore, if my child is exposed to an infected students blood (think about how interesting a bloody accident is to other kids), I won't know that my child has even been exposed. At least with the vaccine, I don't have to worry about my kids getting something life endangering by accident. Yes, I know this is a small risk, but it's one I'm not willing to take. Hope this makes sense. I'm typing while distracted this afternoon!

Sarah
Mom to Alex (3/2002) and Catherine (8/2003)

Actually, Hep B is highly contagious (more so than HIV) and very prevalent in some countries, so it can affect you even if you are not a drug user or worker in the medical field or sexually active. Any contact with blood (a bloody nose, an injury, etc) can expose you, but I honestly would worry more about blood contact from another child (a bite). The reason they give it so early is that you need a series of 3 shots and they are afraid that most people won't complete the 3 shots, but they know that most parents will bring their children in as recommended for vaccinations. I have had my series complete since 1991 and just had titers drawn and they are still fine (meaning no booster needed yet), though I do know others who haven't had it last as long. One doc I work with delayed his children getting them until school age because he felt that since his children were not in daycare, they were at a minimal risk of being exposed to it (short of a bite on the playground or some weird event) and didn't want so many vacs at once.
Traci
~Connor's Mom 02/2004~
Agency paperwork completed - waiting for #2!

I think 1 day old is way too young, even if you think this vaccine a great idea! Our ped doesn't do it until 2 months, though they came for Ds in the hospital. They were so shocked we refused, it was as though we were the first people to ever do that!

Anyway, our Dc are not vaxxed for this as we are all low risk. When they get into their preteens, if it's still considered safe and on the market we will reconsider.

My ped. said the reason they want to give it to them so early is b/c if a mother is Breastfeeding and she has it or contracts it she can pass it to the baby in her milk.

ETA: Interesting, Traci. I had no idea I should be rechecked. I had the series in '94.

DH and I are dentists...high risk profession (and DH does a lot of work on a higher risk population). That is what swayed us to do it this time. However, I will say that we have seriously re-thought the timing for the next baby, and we will be delaying (although not sure what time frame yet).

We waited until 6 months to start. DS was breastfed and cared for at home he had no exposure. I was a healthcare worker so I was immunized. The next baby will probably not get any until at least 2yr old.

I guess this is all pros, but...

The recommendations from the CDC is to get the first shot withing 2 months if the mother is not infected. I suspect they often give it in the hospital because the schedule (first shot, next shot after one month, next shot after 4 months) line up better with regular visits.

Why you should get it:

1) One of the safest vaccines out there
2) It takes 5 months to get the whole series, so it's not something you can just do overnight which leads to (3)
3) You never know when there is an emergency and you child will need a blood transfusion. Even though blood is screened, there is a period when it can be infectious but not test positive as so. (It is a slight chance but there.)
4) Exactly when do you think you child might become sexually active? I ask this because it can be transmitted by sex and if you don't get it as a child you should vaccinate them before they become sexual active, but sometimes that happens before parents think so.
5)The virus can live up to a week on surfaces an be infectious.
6)Unlike HIV there are many documented cases of catching it from things like biting, etc.
7)25% of the acute cases of Hep B have no readily identifiable source.
8)I haven't heard about the need for a booster at 15 years. Antibodies levels do decline, but in a person with a normal immune system they are still at levels to fight the disease. The literature sort of guarantees the virus for 15 years, so that might be where it is from. You can always get a titer later in life to check.
9)Although it is not prevelant in the US, it is in many other parts of the world and we are a global society.

and last:

10) I had to get a new liver for some poor little 19 y.o. who got her first tatoo and got fulminate Hep B from the ink.

So, I guess you can wait, but then you should be very mindful that it is not done yet and your child still needs it.


Jeanne
Mom to Harvey
1/16/03
Jeanne
Mom to Harvey
1/16/03

Jeanne, that's a great list. Thanks for posting it. I also had a young college student go into fulminant hepatic failure after contracting Hep B from a tattoo needle. Unfortunately, she didn't get her new liver.

Vaccine schedules are made with the population as a whole in mind. Most infants in this country are probably not at high risk. However, the Hep B series is three shots, spaced over six months time. When kids get older, they just don't go to the doctor's office that much. So if the shots are moved later, the plain fact is that many many children will slip through the cracks and not get the vaccine. Public health recommendations are made to get the greatest number of people vaccinated with a minimum of resource use.

If anyone wants to say "Well and good, but I will make sure to take my child in for the three shots when they're older, but not old enough that I need to worry about sexual activity or other blood borne contact, and if my insurance won't pay for three regular visits when the kid is ten, then I'll pay for them out of pocket" I think that's your prerogative. For me, I wanted to make sure my son was vaccinated, and by following the recommended schedule it was one less thing I had to worry about.

Agreed. Good points all around. I had to pay out of pocket for my Hep B series when I was in nursing school. Pricey. Since the wee ones will be at the doc regularly, it's easier to make sure that they get the series at the appropriate spacing for effectiveness.

Hep B is so easy to contract through body fluids, I'd rather make sure my baby is well covered and not have to worry once she is older and starts playing with other wee ones. Biting and bleeding are inevitable. I've seen the sad reality of the disease, too.

Agreed. Good points all around. I had to pay out of pocket for my Hep B series when I was in nursing school. Pricey. Since the wee ones will be at the doc regularly, it's easier to make sure that they get the series at the appropriate spacing for effectiveness.

Hep B is so easy to contract through body fluids, I'd rather make sure my baby is well covered and not have to worry once she is older and starts playing with other wee ones. Biting and bleeding are inevitable. I've seen the sad reality of the disease, too.

Great points. I'm pro Hep B, for all the reasons listed above. ;-)

That being said, our girls received first dosing at 1 day, and our boys received it at 2 months, because they were NICU'ers, and that was the decision we came to.