Childhood vaccine

[SHRED]

Why are children given hepatitis B vaccine?


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[Liberal Veteran]

1. To prevent Hepatitis B

[pnwmom]

2. That doesn't explain why they're given it in infancy. n/t

[Ian David]

3. And they need this, because some people believe washing their hands with soap causes Autism. n/t

[truedelphi]

12. Hepatitis B is caused by unsafe needle sharing, and unsafe sex practices.

neither behavior is heavily occurring among those one year and under (Or twelve years and under, for that matter.)

But we have to vaccinate the babies, at the age of one day, because that way when the migraines, the allergies, the paralysis, and even death occur, the Big Pharma people are off the hook. The baby that is affected has no discernible history, so who can say they weren't simply born defective?

Originally Big Pharma was going to campaign to have all twelve year olds have the Hep B series of shots, but then it occurred to them that there is just too much proof of the fact that a twelve year old kid was in great shape until they got the Hep B vaccine, and therefore way too much liability for them.

[mzmolly]

38. Hi TD.

:hi: I didn't realize that 12 was the initial starting age. Interesting.

[pnwmom]

4. You mean, since they wouldn't likely be exposed to it

unless they were sexually active (unless their pregnant mother had it) or otherwise exposed to blood containing it?

My doctor told me why. Technically, they could wait until a child is closer to an age when s/he might be at risk -- when they might begin having sexual activity. But it's easier to get babies vaccinated when they're handy -- for example, in the hospital right after birth. And then at subsequent well baby appointments.

Parents aren't as scrupulous about getting their 10 or 12 year olds in for routine medical care -- but there's no reason it couldn't be started at that age. My 10 year old had the vaccine at the same time as my newborn, soon after it became available.

[Ilsa]

5. What bothers me is starting the vaxes before they've left the hospital.

My kids didn't start the vax program until they were two months old.

The only reason I got the Hep B vax series is that I work in healthcare.

I wonder if the series confers immunity for life, or if boosters will be necessary? If boosters are required, I'd rather initiate the series later.

[SHRED]

7. Hep B vaccine...

...lasts for 10 years is my understanding.

[Warpy]

9. Before they leave the hospital is good

because the virus is shed in breast milk.

[SHRED]

11. Nope

Is it safe for a mother infected with hepatitis B virus (HBV) to breastfeed her infant immediately after birth?
Yes.

http://www.cdc.gov/breastfeeding/disease/hepatitis.htm


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[Warpy]

14. The virus is shed in breast milk

and there is a point of entry as soon as the kid starts to cut its first tooth.

Before they leave the hospital is good. You want to do it as early as possible.

[golfguru]

22. My 2 year old was bitten by another 3 year old in day care.

I hope the 3 year old had the Vaccine shots. Since some parents could be
negligent, it is best if every infant was vaccinated in birth hospital.

[mzmolly]

6. Because an infected, toothless infant might bite your newborn in the hospital

nursery? :P

In all seriousness, pnwmom cleared up the rationale above.

[LeftishBrit]

18. Or 2 years later, an infected toddler might bite your toddler at the day nursery/playgroup...

which is possible!

As I've said, I don't know that it's necessary in infancy if you don't live in a high-risk area/group, but it's pretty desirable if you do.

[mzmolly]

19. Yes I've heard that logic too. I wonder how many times that's actually happened.

Do you know?

[laconicsax]

25. I thought that for you, 1:1,000,000 is too risky.

I guess that's only with vaccine side effects. If it's risks associated with not vaccinating it must not be as risky.

[Name removed]

28. Deleted message

Message removed by moderator. Click here to review the message board rules.

[laconicsax]

30. Keep rationalizing and playing with that straw.

It's a simple choice:

Vaccinate and run a small risk of an adverse reaction.

OR

Don't vaccinate and run a small risk of contracting a potentially fatal disease AND spreading it to everyone you come in contact with AND any immune-compromised persons they come in contact with, etc.

Deciding not to vaccinate affects more than just the person making the decision. People with compromised immune systems rely on herd immunity, as do children too young to get vaccinated AND people who couldn't finish a vaccine series due to an adverse reaction.

But of course, there is a small chance of having an adverse reaction. I'm sure that's far too significant a concern to think about the well-being of other people.

[mzmolly]

31. It's not as simple as you

suggest. For some, the risk of an adverse reaction is greater than the risk of exposure to a given disease. Also, adults are not very good at complying with booster recommendations, rendering the herd immunity argument iffy. I wonder, why does the medical community put so much emphasis on childhood vaccines, while nearly ignoring adult booster recommendations, if protecting others ala herd immunity is the goal? How can we argue that a small percentage of parents are putting others at risk by opting out of vaccination, when according to studies, aprox. 90% of adults are not compliant with booster recommendations?

[laconicsax]

34. Uh huh.

If you're really concerned with preserving herd immunity, why aren't you on here insisting that everyone follow the vaccination schedule from the first infant vaccinations to the final adult booster?

[mzmolly]

37. Did I say I was concerned about preserving herd immunity?

I said that trying to promote herd immunity by focusing on a small segment of the population is misguided. It is you who suggested that if a single child doesn't vaccinate, everyone else is at risk. This, while ignoring the fact that the adult population isn't compliant. So I ask ... why aren't YOU here insisting that everyone follow the vaccination schedule from the first infant vaccinations to the final adult booster?

I suggest that anyone who promotes vaccination should focus on ALL age groups. I've said that repeatedly. When public health officials do, I'll take their pleas about promoting herd immunity more seriously.

[laconicsax]

39. And you wonder why you're called anti-vax.

You've just admitted you don't take public health officials seriously on the topic of vaccination!

You argue about health policy and DON'T RESPECT THE PROFESSIONAL OPINION OF PUBLIC HEALTH OFFICIALS.

Why should anyone take you seriously after that admission?

ETA: Hell, downthread you're telling a nurse that you know better. Welcome back to DU, mzmolly!

[mzmolly]

40. I don't wonder why I'm called anti-vax. I've stated that it's an orchestrated attempt to shut down

debate.

To clarify, I stated that I believe public health officials need to improve on promoting vaccination in all age groups, if the concept of herd immunity is to be taken seriously. Don't you agree?

Also, I'm not telling a nurse I "know better". I'm engaging in a respectful conversation about who is at risk of contracting hep b.

Speaking of nurses, I have two nurse friends who were among the first to promote vaccine safety in my area. They are both involved in a local vaccination choice group. Both have testified about witnessing vaccine side effects, first hand. I also have three members of my family who are medical professionals, two nurses among them. They don't agree on everything, either.

As you know there are "PUBLIC HEALTH OFFICIALS" who are deemed "anti-vaccine" as well, so your point about blind respect for so called authority, is moot.

[laconicsax]

41. Of course it's a conspiracy to silence you.

:eyes:

[mzmolly]

42. It's a straw man, meant to silence

many.

[laconicsax]

43. Keep hammering #7!

1. Claiming to be “pro-safe vaccine” while being unrelentingly critical about vaccines
2. The “vaccines don’t work” gambit
3. The “vaccines are dangerous” gambit
4. Preferring anecdotes over science and epidemiology
5. Cherry picking and misrepresenting the evidence
6. The copious use of logical fallacies in arguing
7. Conspiracy mongering
8. Trying to silence criticism, rather than responding to it

[mzmolly]

44. I noted the desire for you to use the word "conspiracy" above, so you could trot

out the handy/official talking points. Keep hammering no. 8!

[laconicsax]

46. "I've stated that it's an orchestrated attempt to shut down debate"

Uh huh. Ok. Sure. Whatever you say.

[Warpy]

8. Hep B is endemic in some cultures

and it's very easily transmitted, unlike HIV which follows the same pattern but is relatively hard to catch.

The vaccine can be given to infants and it makes sense to protect them as early as possible.

[SHRED]

10. how would an infant get it?

[LeftishBrit]

16. Small children get a lot of cuts and scratches and are not very hygiene-conscious.

If they touch something that's come into contact with someone else's blood or body fluids, or if they share toothbrushes, etc., they could get it. It's much more infectious than HIV. This is apart from the risk of maternal tranmission.

Whether *all* infants need it is another matter, but certainly it would be recommended for those in contact with high-risk populations.

[SheilaT]

13. I don't fully understand why anyone

not realistically at risk needs to get it.

[Heddi]

23. what is "realistically at risk," though?

Most people aren't at risk for most things until the moment they become at risk for that thing, and at that point it's too late to be protected against it.

Most children aren't at risk for HepB...until they are under the care of a daycare operator who doesn't wash their hands after having a bowel movement, or who doesn't understand microbiology and just because the shit (literally) isn't visible on your hands doesn't mean it's not there, and handles your child and spreads HepB to them.

most children aren't at risk for HepB...until they are on the playground and get bitten by a child with HepB

most children aren't at risk for HepB...until they are born to a mother who practices unsafe sex practices or who uses IV Drugs, who has contracted HepB since her initial HepB titer done earlier in pregnancy...

[mzmolly]

27. I've read that hep b is not spread via feces, but hep a can be.

http://www.tpchd.org/files/library/c941c07c68541789.pdf

Here's more. http://www.ccohs.ca/oshanswers/diseases/hepatitis_b.html

Saliva of people with hepatitis B can contain the hepatitis B virus, but in very low concentrations compared with blood. Injections of infected saliva can transmit the virus, so bite injuries can also spread the disease. There are no reports of people getting hepatitis B from mouth contact with infected CPR manikins or mouthpieces of musical instruments.

Other Body Fluids and Tissues

Hepatitis B is found in semen and vaginal secretions. The virus can be transmitted during unprotected sexual intercourse, and from mother to infant during birth.

Synovial fluid (joint lubricant), amniotic fluid, cerebrospinal fluid, and peritoneal fluid (found in the abdominal cavity) can contain the hepatitis B virus, but the risk of transmission to workers is not known.

Feces, nasal secretions, sputum, sweat, tears, urine, and vomit have not been implicated in the spread of hepatitis B. Unless they are visibly contaminated with blood, the risk of contracting hepatitis B from these fluids in the workplace is practically nonexistent.

Hepatitis B is not transmitted by casual contact. For example, hospital employees who have no contact with blood, blood products, or blood-contaminated fluids are at no greater risk than the general public. However, the virus can spread through intimate contact with carriers in a household setting. Why this happens is not completely understood. Somehow, the virus can find its way into the bloodstream of fellow family members possibly because of frequent physical contact with the small cuts or skin rashes. The virus can also spread through biting and possibly by the sharing of toothbrushes or razors. It is not spread through sneezing, coughing, hand holding, hugging, breastfeeding, sharing eating utensils, water or food.

[Heddi]

33. look up occult blood in feces

fecal matter as a vector because of blood that can be in the fecal matter

[mzmolly]

35. I don't doubt you, but I'm having trouble

finding specific information regarding a risk in this regard. Help, is appreciated.

[SheilaT]

29. Well, let's see. Just how common is HepB?

The only person I know of who actually got it was a gay man, and he got it about thirty years ago.

How about we vaccinate the adult day-care operators instead? And isn't the main way to get it through sex? How many infants and toddlers are having sex?

Heck, I was pretty sexually active because I came of age in the Golden Age after the Pill and before Aids, and I never got an STD.

[LeftishBrit]

47. Worldwide, extremely so.

About a quarter of the world's population is estimated to be infected with the virus - close to 2 billion people.

In areas of the world where it is very common or moderately common, transmission between children is in fact thought to be one of the commoner methods of transmission.

The United States and Western Europe are relatively low-prevalence areas. In Britain, infant vaccinations are not universal in infancy tend to be targeted to groups and places at higher risk; e.g. those with high numbers of recent immigrants from higher-risk countries. I suppose some of it is a judgement call about how great the risk is to a particular child or group of children.

*But*

'isn't the main way to get it through sex? '

No, that is *one* way of getting it. It can be caught through *any* exposure to blood and other body fluids. If you live in an area where it isn't endemic, then sex may indeed be one of the main ways. If you live in an area where many people are infected, then there are many other ways to get it: perinatal transmission of course, bites, sharing toothbrushes, having a scratch or cut and touching something that's been contaminated with blood or other body fluids, eating pre-chewed food, etc. It isn't spread through casual contact, but if you *are* exposed to the virus then you're very likely to get it; it's much more infections than HIV, though usually less devastating (but still quite bad enough) to those who contract it.

I'm certainly not saying that *every* child has equal need of the vaccination, and if people live in a very low-risk area and don't intend to travel when their children are young, then they may decide that it's not necessary. But I think there's an additional factor in some people's comments here of 'It's transmitted through sex and drugs! Are you suggesting that my precious baby is at risk of an STD!?' In fact it's transmitted in many other ways, some of which would be so low-risk as to be theoretical for HIV, but are much more likely to lead to infection in the case of Hepatitis B. Also infants and young children are more likely than adults to develop chronic infection if they do get the virus.

[LeftishBrit]

15. The reasons for getting it in infancy...

are (a) to prevent maternal transmission; (b) if young children live in a community where Hepatitis B is common, they may get it through cuts and scratches.

In the UK, it is not given routinely in infancy, but is given to those seen as being at high risk.

In places where hepatitis B is or has been common, vaccination has significantly reduced the rates of liver cancer, including childhood-onset liver cancer.

[Heddi]

17. Because they **Can be** exposed to Hepatitis B through many ways

1) Through vaginal birth of a mother who is HepB positive. Vaginal birth = blood. Blood-borne transmission is one of the ways that Hepatitis B is transmitted from person to peron

2) Through exposure to blood or body fluids of other people infected with HepB. Example: being bitten by a child who has hepatitis B. Coming into contact with the blood or fecal matter of another child who has HepB (think daycare, playing centers, other places where children are in close contact with one another)

Not everyone lives in perfectly sanitary conditions. Not everyone practices safe sex. Not everyone uses a new needle when they shoot up. Sometimes, especially in poor migrant/immigrant communities, many people live in tight spaces. Children can be exposed to blood and body fluids (urine, feces, etc) of other people who may have HepB just through the course of their daily lives. Not every child lives in a household where family members wash hand after using the bathroom, or before handling food, or before touching other people.

As wonderful as it would be if every daycare was 100% hygenic in everything they did, there are many schools and daycare centers that hire people who do not understand the importance of handwashing after using the bathroom, before handling food, or before touching other people.

While HepB certainly is a disease that can be spread through sexual contact and sharing needles, it is also a disease that can be spread through exposure to blood and bodily fluids in non-sexual, non-IV Drug use ways.

I'm an RN in a busy, inner city ER. I have the Hepatitis B series. Why? I don't have any plans on having sex with any of my patients, or sharing needles with them. But I am exposed to blood and bodily fluids, and therefore my risk is increased. Just like many children have an increased risk through play, diaper changes, sub-optimal living & learning situations, etc.

[mzmolly]

20. As an RN,

I can understand the need for you to be vaccinated with every available vaccine and booster shot.

[Heddi]

24. But why not children, since they have such an exposure?

Daycare centers and pre-schools are COVERED, no pun intended, in shit. 30-40+ diapered children running around with runny noses and runny asses and puking from time to time....every child in that environment, intended or not, is going to become exposed to another child's fecal matter, snot, spit, vomit, pee, blood at some point.

Children bite. They scratch, they play, they get scratched, they get abrasions, they put things in their mouths as a way of identifying objects, they put fingers in mouths without washing them, they scratch butts and touch things without washing their hands...

I really don't see how a child's risk is really any different than mine is. Hell, at least I wear gloves before all interactions with patients, and have hand sanitizer at ever turn, and I wash my hands throughout the shift, and I have taken multiple classes on microbiology and disease transmission and biology and chemistry and vectors and viruses. I know not to touch my face, or my hair while at work, and I never wear contacts because I don't want to touch my eyes, and I keep my work shoes at work, and change scrubs before I leave in the morning....

But no child does those things. Children don't play wearing gloves, and their play clothes are their sitting at home clothes, and their shoes at school are shoes at home, and they don't wash their hands and rub their noses and touch their eyes and their butts....

I guess I don't see how I need the boosters any more than a child, when (as long as I use universal and standard precautions, and wash my hands before and after patient contact, etc) my risk is actually lower than a child's.

[mzmolly]

26. I've listed the risk factors below. You are in a high risk group.

http://www.comeunity.com/adoption/health/hepatitis/wexler.html

Who is at risk for HBV infection?

About 5% of people in the U.S. will get infected with HBV sometime during their lives. If you engage in certain behaviors, your risk may be much higher. You may be at risk if you:

have a job that exposes you to human blood
share a household with someone who has lifelong HBV infection
inject drugs
have sex with a person infected with HBV
have sex with more than one partner during a six-month period
received blood transfusions in the past before excellent blood testing was available (1975)
are a person whose parents were born in Asia, Africa, the Amazon Basin in South America, the Pacific Islands, Eastern Europe, or the Middle East
were born in an area listed above
were adopted from an area listed above
are an Alaska native
have hemophilia
are a patient or worker in an institution for the developmentally disabled
are an inmate of a long-term correctional facility
travel internationally to areas with a high prevalence of hepatitis B

...


How is HBV spread?

HBV is found in blood and certain body fluids—such as serum, semen, vaginal secretions—of people infected with HBV. HBV is not found in sweat, tears, urine, or respiratory secretions. Contact with even small amounts of infected blood can cause infection.

Hepatitis B virus can be spread by:

unprotected sex
injecting drug use
an infected mother to her child during birth
contact with the blood or open sores of an infected person
human bites
sharing a household with a chronically infected person
sharing items such as razors, toothbrushes, or washcloths
pre-chewing food for babies or sharing chewing gum
using unsterilized needles in ear or body piercing, tattooing, or acupuncture
using the same immunization needle on more than one person

Hepatitis B virus IS NOT spread by:

casual contact like holding hands
eating food prepared by an infected person
kissing or hugging
sharing silverware, plates, or cups
visiting an infected person's home
sneezing or coughing

http://www.hepb.org/hepb/abc.htm

Blood tests show that certain occupational groups have different risks of getting hepatitis B.

http://www.ccohs.ca/oshanswers/diseases/hepatitis_b.html">Risks to Occupational Groups


High (over 20%) Pathologists, biochemistry and hematology laboratory personnel, dialysis staff

Intermediate (7-20%) Hospital nurses, laboratory personnel other than those in high risk groups, staff of institutions for the developmentally handicapped, dentists

Low (less than 7%) Administrative hospital staff, medical and dental students, healthy adults

Also, hep b is spread in the same manner AIDS is from what I've read. It's highly unlikely that a child with aids will spread the disease to a playmate, as you know. So, while I'm not opposed to anyone getting the jab for their child, I feel it's a slippery slope to suggest that every child should be vaccinated because it's likely they may be infected, otherwise.

[Heddi]

32. you don't think children are at risk for

contact with the blood or open sores of an infected person
human bites
sharing a household with a chronically infected person
sharing items such as razors, toothbrushes, or washcloths
pre-chewing food for babies or sharing chewing gum
using unsterilized needles in ear or body piercing, tattooing, or acupuncture


???

[mzmolly]

36. I don't think the vast majority of infants and toddlers are at risk of contracting hep b.

On the other hand, people who are in close contact with an infected person are at an increased risk of exposure regardless of age.

I think being at risk for being bitten at day care etc. (generally speaking) is another matter.

[Heddi]

45. well, the problem lies in the fact that most people who have hepatitis don't know they are infected

equally, doctors (ob and peds) don't know the Health status of everyone who lives with or comes in contact with the child on a regular basis

because hepatitis is a silent epidemic, and more people are infected than people who know they are infected, I can see the prudence of vaccinating children against a virus that is so devistating to children more than it is for adults

[Liberal Veteran]

21. This might be why as well...

Almost all newborns and about 50% of children who become infected with hepatitis B develop chronic hepatitis. Less than 5% of adults who are infected with the hepatitis B virus develop the chronic condition.

Chronic hepatitis B infection increases the risk for liver damage, including cirrhosis and liver cancer.

People who have chronic hepatitis B can transmit the infection. They are considered carriers of the disease, even if they do not have any symptoms.