Hepatits B Vaccination

[Anonymous]

I learned recently that one can choose whether or not to have a Hepatitis B vaccination administered to a newborn at the hospital. What are the pros and cons of getting the vaccine at the hospital versus waiting to get the vaccine?

[Anonymous]

In DC it's now required unless there's a medical indication not to have it done.

[cmcoughlin]

If you do not get it in the hospital and wait to have it done at the pediatrcians your insurance may not cover the vaccine and you will have to pay for it. I asked my peds office the same question.

[Anonymous]

In DC it's now required unless there's a medical indication not to have it done.

and

If you do not get it in the hospital and wait to have it done at the pediatrcians your insurance may not cover the vaccine and you will have to pay for it.

Neither of these statements are true. Yes, DC requires it for school entry (which you can get an exemption for by the way); however that has nothing to do with a baby receiving it at birth. There is no state or federal law requiring shots at birth or at any time, ever, for that matter. Also, Hep B is a *series* of shots. Everyone who recieves the first shot at the hospital also receives follow-up shots from the pediatrician. Insurance will always pay for vaccinations. The pedicatrician who told you this had no idea what he was talking about or was purposely trying to coerce you into doing what he wanted. What do you think happens when babies are born outside of the hospital? Their insurance still pays for their shots, no matter when their parents bring them in to the doctor.

There is no reason to give a day old baby a Hepatitis B vaccine. For those who don't know, Hep B is transmitted the same way as HIV. Newborn babies are not at risk of contracting this disease, unless perhaps their parents have it. Otherwise, unless your newborn baby or small child is having unprotected sex or sharing needles with their buddies, you can VERY safely delay this one.

The drawback of administering this shot at the hospital is that the ingredients in the vaccine have all sorts of chemicals that I *personally* would rather not have injected into my brand new baby.

[Anonymous]

I went ahead and allowed my son to get the Hep B, mostly because I was too exhausted to research and protest it, but now if I have another I'm thinking I will delay this vaccine. As the PP said, Hep B transmissions are different than, say mumps or polio, so I don't think the vaccine is as important to get right away, and I'm worried about some of the stuff I've read about the effect of multiple vaccines on young minds. Plus, my DS had several reactions to vaccines during his first 6 months - severe fussiness and fever - so I'd be even more cautiously about doing vaccines when they are tiny.

[Anonymous]

The vaccine is given in the nursery to prevent maternal transmission to the infant. Most pregnant women are tested during the pregnancy but they, however unlikely, can be infected later in the pregnancy.

Chronic infection occurs in:

* 90% of infants infected at birth

"Infants born of HBsAg-positive mothers should receive Hepatitis B Immune Globulin (Human) (HBIG) and monovalent Hepatitis B Vaccine (Recombinant) within 12 hours of birth and should complete the hepatitis B vaccination series according to a particular schedule. "-CDC


From the WHO, "Hepatitis B is one of the major diseases of mankind and is a serious global public health problem. It is preventable with safe and effective vaccines that have been available since 1982. Of the 2 billion people who have been infected with the hepatitis B virus (HBV), more than 350 million have chronic (lifelong) infections. These chronically infected persons are at high risk of death from cirrhosis of the liver and liver cancer, diseases that kill about one million persons each year. Although the vaccine will not cure chronic hepatitis, it is 95% effective in preventing chronic infections from developing, and is the first vaccine against a major human cancer. In 1991, the World Health Organization (WHO) called for all children to receive the hepatitis B vaccine, and 116 countries have added this vaccine to their routine immunization programmes. "

[Anonymous]

"In DC it's now required unless there's a medical indication not to have it done."

Not true! I gave birth in DC and it was not required at the hospital..though they do not openly share that information. They simply hand you a form to sign and you simply say no. Our pediatrician gives the shot at two months in a combined dose, so the hospital shot was unecessary and simply a duplicate.

The hospitals give Hep B as a public health protection for parents who do not do follow up vaccinations. We are not anti vaccine at all but saw no reason, nor did our doctor to give our newborn an unnecessary vaccination just because the hospital does it. DC public school may very well require Heb B prior to enrollment but it did not need to administered at the hospital.

[Anonymous]

I delived at Sibley in Aug '07 and my daughter got her first Hep B shot the day after she was born. Of the many things I researched before she was born, vaccines was not one of them (can you believe it?!?). In hindsight, I DEFINITELY would have refused the Hep B (esp. since she was 3 weeks early and not even 6lbs!) and gotten it later. I've had my full course and I know I am Hep B negative, so there was no risk of maternal transmission. My advice is do your own research, but consider delaying the 1st shot (heck, i didn't get my course of Hep B till I was in my late 20's/early30's!).

[Anonymous]

The vaccine is given in the nursery to prevent maternal transmission to the infant. Most pregnant women are tested during the pregnancy but they, however unlikely, can be infected later in the pregnancy.

Obviously if the mother herself has Hep B, her newborn baby should get the vaccine as soon as possible. Also, if the mother has unprotected sex with a new partner or shared needles after being tested in early pregnancy, then she is at risk for acquiring it and passing it to her baby -- again, the newborn should absoutley be given the vaccine immediately.

The big beef I have with this vaccine is that they assume we are not capable of being honest about any potential risky behavior during our pregnancy. "Well , we'll just do it because mommy might be sharing drug needles and we just can never know - even though her test six months ago was negative - so we might as well give the baby the shot." Blech. I hate our healthcare system. Yes, Hepatitis B is a serious health concern and an awful disease, but it is not easy to get. You actually need to engage in risky behavior to get it.

The hospitals give Hep B as a public health protection for parents who do not do follow up vaccinations.

This is the real reason they give this shot at birth -- because they are afraid they will never see your child again at the doctor's office. I think most pediatricians will agree that for parents who do not engage in risky behavior during pregnancy, who tested negative for Hep B themselves, and who plan on continuing pediatric care, there is absoultely no reason to administer this shot to a newborn baby.

[Anonymous]

I gave birth at VHC and they didn't give it there. My doctor (Evers and Thiede) who are pretty conservative on shots told me that there was no real need to do this until I think around eight months. I wound up going on a trip abroad when dd was around 4 months and asked for the shot as I was concerned about if she, god forbid, had to go to a hospital and could have been more vulnerable. Now I think I was being a little dramatic but doctor said fine--they are the nicest doctors there.

[Anonymous]

"The big beef I have with this vaccine is that they assume we are not capable of being honest about any potential risky behavior during our pregnancy. "Well , we'll just do it because mommy might be sharing drug needles and we just can never know - even though her test six months ago was negative - so we might as well give the baby the shot." Blech. I hate our healthcare system. "

Couldn't agree more! DS had a blocked tear duct and one eye was a little weepy but not thick discharge. The peds at the hospital told us it was probably nothing but they would HAVE to prescibe an antibiotic eye ointment because it could be a serious infection. This was at 5pm prior to check out and we had a morning appointment with our pediatrician. We asked what type of infection and how servere this could be and the resident just insisted that it was important so we filled it and put in his eye. Our pediatrician found it really annoying, pointed out that it was clearly just a blocked duct and told us they only do that in case the mother had an STD.

I'm not anti antiobiotic but I strongly object to a resident or doctor witholding the reason for prescribing something. They probably assume that someone who did have an STD would not admit it and were basically tricking patients. Bad policy.

[Anonymous]

Totally concur with PP. I highly recommend checking out Dr. Sears' new vaccine book. He discusses all of the recommended childhood vaccines, the diseases, how the vaccines are made, the ingredients, the timing of the shots, etc. He tries to be objective and not persuasive and I think that he mostly succeeds at this. He also discusses frankly the fact that vaccinations are not given a lot of discussion in medical school--they basically are taught what the government guidelines are and what the pharmaceutical companies put out as far as safety, etc.

The discussion in the book about Hep B is interesting, because he goes into the statistics that were used to justify making this a vaccine that every child is recommended to receive. Unless your child is in a high risk category (mother has Hep B, someone in household or frequent contact has it, etc.) it's unlikely they'll be exposed. It comes down to the individual vs. reducing the cases in society, the number of reported cases has gone down since they started giving the vaccine to all kids. He jokingly recommends that if your teenager comes home with a tattooed boyfriend, time to get Hep B vaccine because tattoo needles is one way the disease is spread.

I just got the book from the library today and plan to purchase it before our next child is born--with the first we just did what the docs told us to do, but I think we'll do a delayed schedule and not do all of the vaccinations next time. Interestingly, in West Virginia and Mississippi, vaccinations are mandatory, and the state can remove children from their homes if parents do not vaccinate. Scary!

[Anonymous]

What is the name of the book by Dr. Sears?

[Anonymous]

"The Vaccine Book" -- I highly recommend it as well!

[Anonymous]

The Vaccine Book: Making the Right Decision for Your Child

Great even-handed discussion of vaccines from a respected pediatrician!

http://www.amazon.com/Vaccine-Book-Decision-Parenting-Library/dp/0316017507/ref=pd_bbs_sr_1?ie=UTF8&s=books&qid=1213713133&sr=8-1