Hepatitis B: what is the reason for the vaccination of children?
August 18, 2013 6:14 PM Subscribe
I have just become aware that it has been added to the schedule of routine immunizations for children. I'm wondering why.
Per WebMD (admittedly not my favorite source, but this is pretty straightforward):
posted by devinemissk at 6:20 PM on August 18, 2013 [1 favorite]
Best answer: cdc faq
While Hep B is commonly known as a sexually transmitted disease, here are some ways that it is also contagious:
posted by bilabial at 6:22 PM on August 18, 2013
While Hep B is commonly known as a sexually transmitted disease, here are some ways that it is also contagious:
- Sharing items such as razors or toothbrushes with an infected person
- Exposure to blood from needlesticks or other sharp instruments
Because kids might share toothbrushes, and because any person might get exposed to a needle stick or other blood source.
Chronic Hep B is not fun. from the faq above:
How likely is it that acute Hepatitis B will become chronic? The likelihood depends upon the age at which someone becomes infected. The younger a person is when infected with Hepatitis B virus, the greater his or her chance of developing chronic Hepatitis B. Approximately 90% of infected infants will develop chronic infection. The risk goes down as a child gets older. Approximately 25%–50% of children infected between the ages of 1 and 5 years will develop chronic hepatitis. The risk drops to 6%–10% when a person is infected over 5 years of age. Worldwide, most people with chronic Hepatitis B were infected at birth or during early childhood.
posted by bilabial at 6:22 PM on August 18, 2013
Because it's a sucky disease, and because vaccination rates fall off sharply after age 2. Because the vaccination schedule requires 3 shots, each 6 months apart, the best way to get all the shots in before parents (statistically speaking) stop taking their kids to well-child appointments is to start them very early in infancy.
posted by KathrynT at 6:24 PM on August 18, 2013 [7 favorites]
posted by KathrynT at 6:24 PM on August 18, 2013 [7 favorites]
Best answer: Most importantly, most people who have Hep B do not know they carry the virus, so not chewing food for a baby or whatever just doesn't seem critical.
It's kind of like the loaded gun theory of disease management. Everyone has it and everyone has the potential to make one poorly informed choice that leads to a child (or adult!)becoming infected.
posted by bilabial at 6:24 PM on August 18, 2013
It's kind of like the loaded gun theory of disease management. Everyone has it and everyone has the potential to make one poorly informed choice that leads to a child (or adult!)becoming infected.
posted by bilabial at 6:24 PM on August 18, 2013
You've gotten good answers already but I would add that usually when a vaccine is added to the childhood schedule it is because the people who make these decisions have projected that the benefits will significantly outweigh the risks.
If a disease is causing significant morbidity and/or mortality in a given population and is preventable through vaccine, then it's probably going to be added to the schedule. Given that hepatitis B is incurable and has the potential to cause severe chronic disease resulting in death, there would have to be a really good reason not to want everyone to be protected.
posted by treehorn+bunny at 6:29 PM on August 18, 2013 [5 favorites]
If a disease is causing significant morbidity and/or mortality in a given population and is preventable through vaccine, then it's probably going to be added to the schedule. Given that hepatitis B is incurable and has the potential to cause severe chronic disease resulting in death, there would have to be a really good reason not to want everyone to be protected.
posted by treehorn+bunny at 6:29 PM on August 18, 2013 [5 favorites]
It's not new - it's been on the recommended immunizations schedule for neonates and infants since I was in nursing school at least, which means 15+ years. The justification for newborns is that the virus can be transmitted from the mother during childbirth, but some mothers are tested for Hep B as part of routine prenatal care, so peds and parents often delay vaccination until the two-year visit, school entry, or later. The justification for doing the series as a catch-up in school-aged kids is that, as with HPV vaccination, children will be fully covered before they're likely to be exposed to the virus through sexual contact. (That rationale isn't quite so clear-cut when it comes to exposure through blood, which could happen at any age, but as KathrynT says, we gotta catch them when we can.)
posted by gingerest at 6:29 PM on August 18, 2013 [1 favorite]
posted by gingerest at 6:29 PM on August 18, 2013 [1 favorite]
It also means we're hopefully having a lot more herd immunity to it, I would guess.
posted by geek anachronism at 6:31 PM on August 18, 2013
posted by geek anachronism at 6:31 PM on August 18, 2013
Best answer: Also, travel. It's really common in Asia. From the WHO: "Hepatitis B prevalence is highest in sub-Saharan Africa and East Asia. Most people in these regions become infected with the hepatitis B virus during childhood and between 5–10% of the adult population is chronically infected."
A child might stay in their hometown but they could interact with someone who had travelled to Africa or Asia on holiday, and it's such a horrible and preventable condition. I know someone who has had a spleenectomy as a young adult because of Hep B contracted when she was born, her mother just not realising she had a very very mild infection.
posted by viggorlijah at 7:59 PM on August 18, 2013 [1 favorite]
A child might stay in their hometown but they could interact with someone who had travelled to Africa or Asia on holiday, and it's such a horrible and preventable condition. I know someone who has had a spleenectomy as a young adult because of Hep B contracted when she was born, her mother just not realising she had a very very mild infection.
posted by viggorlijah at 7:59 PM on August 18, 2013 [1 favorite]
Because it's a very widespread but fully preventable infectious disease that causes cirrhosis of the liver and liver cancer, especially when combined with alcohol abuse. If you spend time in East Asia you will find it's a very common topic of discussion because it's so rampant. With the world so inter-connected these days, it makes sense to vaccinate against it.
posted by Dansaman at 9:13 PM on August 18, 2013 [1 favorite]
posted by Dansaman at 9:13 PM on August 18, 2013 [1 favorite]
Best answer: Yeah, hepatitis B is the only one of the hepatitis viruses that can become chronic, and is incurable, because it's a DNA virus, whereas the others are RNA viruses. The DNA can integrate into the host genome.
posted by honeybee413 at 11:48 PM on August 18, 2013
posted by honeybee413 at 11:48 PM on August 18, 2013
Best answer: "Hepatitis B vaccine has been successfully integrated into the childhood vaccination schedule, contributing to a 96% decline in the incidence of acute Hepatitis B in children and adolescents. Currently, approximately 95% of new HBV infections occur among adults, and unvaccinated adults with behavioral risk factors or who are household contacts or sex partners of HBV-infected persons remain at risk."
(Page is recommending that adults receive the vaccine as well.)
posted by dhartung at 3:04 AM on August 19, 2013
(Page is recommending that adults receive the vaccine as well.)
posted by dhartung at 3:04 AM on August 19, 2013
Response by poster: Thanks for the prompt answers. I thought of hepatitis B as a disease of the "at risk population" healt care field. I know better now.
posted by francesca too at 6:02 AM on August 19, 2013
posted by francesca too at 6:02 AM on August 19, 2013
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