Talk about too much information! We are constantly being bombarded from all sides—friends, health care providers, television, the Internet—regarding the best things to do for our children. And it seems that no topic is more heavily discussed and debated than childhood vaccines. What information is correct? And whose advice do we take?
Immunizations have likely become a hot topic for several reasons. First of all, the number of vaccines has greatly increased. 30 years ago, a total of 12 immunizations were recommended for otherwise healthy children between birth and the age of 18; today that number has approximately quadrupled. What’s more, a couple of vaccines that were formally given as oral “drinks” have been found to be safer or more effective in shot form, making the vaccines appear even more burdensome.
Perhaps somewhat less discussed are the diseases that the vaccines were designed to prevent. We may have heard of someone’s great uncle that contracted polio and had difficulty walking, but it would be unlikely at this point to come across someone newly infected with that virus in the United States. And most pediatricians who practiced prior to the late 1980s, when the “Hib” vaccine was put into routine use, can tell stories about treating patients with hemophilus influenzae, a type of bacteria which may cause meningitis.
It’s the relative absence of vaccine preventable diseases that in some people’s minds calls into question the need for all these shots. In a sense, immunizations have become victims of their own success!
Another case in point is Hepatitis B. The vaccine has been in widespread use and on the recommended immunization schedule for children since the early 1990s. This prevention strategy has contributed to a decrease in new cases of 72% (2011 statistics).
But Is My Child at Risk?
In order to make the best decisions for your child on vaccines, it’s helpful to learn more about the diseases they prevent. What is Hepatitis B? How would my baby get infected? And what would happen if she did get the virus?
Hepatitis B is an illness caused by a virus that is transmitted from person to person. Although it is primarily transmitted through contact with blood or body fluids of an infected person, including through sexual contact or mother-child transmission during birth, cases through close household contacts absolutely do occur.
Once a person gets the virus, any of several things may happen. Some people have no symptoms at all. Others may get flu-like symptoms: loss of appetite, nausea, vomiting, joint or muscle aches. Some may get jaundice, which is a yellowing of the skin and eyes; however, not everyone who has symptoms develops this, which may lead an affected person to think that they have “just a bad bug.”
Although most people recover completely, a small percentage of patients will develop a particularly severe form of Hepatitis B that causes liver damage. And among those who do recover, a significant percentage go on to have a chronic form of the disease. These people may at any time later in life become severely ill from liver damage. Liver cancer is also a risk for such chronically infected individuals.
Another risk of the chronic form of hepatitis B—even among those who have no symptoms—is that a chronically infected person may continue to be at risk to pass the virus on to others.
But in the Newborn Period? Why Not Worry about It When He’s Older?
It’s been found that the tendency to develop chronic hepatitis B varies with age. While just five percent of adults become carriers—people who continue to have the virus, even if not sick—that figure is 90 percent for infants who become infected in the newborn period.
How likely is it that the smallest patients will become infected? Although pregnant women are generally screened for hepatitis B, no test is foolproof. What’s more, given all that needs to be remembered in the hectic atmosphere of bringing a new baby into the world, occasionally a Mom’s hepatitis status may be forgotten or misinterpreted. And it’s simply too easy for a young infant to come in contact with other people, many of whom may not know they’re carriers of the virus. For these reasons, by far the safest plan of action is for the newborn to receive a dose of the vaccine within 24 hours of birth.
The vaccines for hepatitis B have been well studies and have been given for decades. Side effects, if any, are very likely to be minimal and include a little discomfort where the shot is given and, occasionally, a small fever. Serious side effects are extremely uncommon and, as with all recommended vaccines, the chance of an unvaccinated child getting a serious version of the disease are much, much greater.
What Else Can I Do to Protect My Baby from Hepatitis B?
Other than saying yes to the vaccine, an expecting Mom should definitely know her hepatitis B status; her obstetric provider should have that information. And for mothers who are hepatitis B positive, there is an additional preventive measure that’s recommended. This additional step involves an injection of hepatitis B immune globulin. This can be given at the same time as the vaccine shortly after birth; it’s designed to provide antibodies to any hepatitis B virus picked up from the newborn’s mother. Used along with the vaccine, it can reduce the likelihood of chronic infection in the baby.