Hepatitis b is a liver disease caused by a virus with the same name. The infection may be acute or chronic and symptoms can include fever, malaise, fatigue, jaundice, abdominal tenderness, and elevated liver enzymes. While a person can be quite ill with this infection, the treatment is supportive and aimed at providing comfort. The vast majority of patients recover within eight weeks of an acute episode of the infection without any long term complications.
Parents are told that hepatitis b is a potentially life-threatening illness. What they are not told is the real risk of serious complications from the disease and that it is very unlikely their child will contract hepatitis b.
The virus is spread by coming in contact with the blood of an infected person. The vast majority of hepatitis b infections occur in persons considered to be in "high risk groups." These groups include adults who inject illicit drugs or are chronic alcoholics; individuals who have been diagnosed with a sexually transmitted disease; and men who have sex with men. Only 1.25 percent of infected individuals may develop liver cancer 30 years after being diagnosed as a chronic carrier.(1) Despite the low incidence of cancer, the hepatitis b vaccine has been called the first "anti-cancer vaccine." Considering the risk factors of those who contract hepatitis b, it could well be the alcohol or the drugs that cause the cancer, not the virus.
The number reported cases of acute hepatitis b infection have steadily declined, from 18,003 cases in 1991 to 8,036 cases in 2000.(2) Of all persons who are exposed to the hepatitis b virus, 50 percent will develop no symptoms and 30 percent develop only mild flu-like symptoms. In both circumstances, the person will acquire life-time immunity to the virus.
Approximately 20 percent of persons who contract hepatitis b will develop fever, abdominal tenderness and the telltale sign of the infection: jaundice. In this subset of patients, more than 95 percent recover fully and will be immune for life. That means of all persons who are both exposed to the virus and become measurably ill, only 5 percent have the potential to become chronic carriers of the hepatitis b infection.(3)
So, let's do the math: If 8,000 persons were diagnosed in the U.S. with hepatitis b in 2000, and 5 percent of those became chronic carriers, that would be 400 persons. If approximately 1 percent of chronic carriers go on to develop liver cancer, 4 adults might be prevented from contracting liver cancer by massive vaccination of more than four million newborns born each year.
Why babies?
In 1991, the Advisory Committee of Immunization Practices (ACIP) began recommending the hepatitis b vaccine for newborns within the first 48 hours of life. Between 30-50% of children who develop adequate antibody after three doses of vaccine will loose detectable antibody within 7 years.(4) That means that many children vaccinated as babies will not have a measurable level of antibodies by the time they are seven years of age; most will not retain antibodies into adulthood.
The government pushed hepatitis b vaccination on infants as part of a strategy to eliminate the hepatitis b virus from the general population. Vaccination programs that targeted high-risk groups did not work because many adults refused the vaccine. Finding it difficult to vaccinate high risk groups with three doses of the vaccine, the government advisors decided the only way to control the problem was to vaccinate the entire population, starting at birth.
Newborns have been targeted for vaccination because they are accessible. Ask any parent who has tried to refuse this vaccine before leaving the hospital and you will hear horror stories of unrelenting pressure placed on them by nurses and doctors wanting to vaccinate their precious newborn.
If the hepatitis b vaccine is avoided at birth, then it is administered during the routine two month office visit...along with five other vaccines: polio (three strains), the Hib (H. influenza), Prevnar (seven strains of streptococcus), DTaP (diphtheria, tetanus, pertussis) and now, the new Rotateque (four strains of rotavirus). That is a total of 19 vaccine antigens and multiple doses of chemicals injected on the same visit into an eight week old baby.
Clearly, the universal vaccination of all newborns with hepatitis b vaccine is a policy that is based on convenience and opportunity, not need. Parents would be wise to investigate the risks of hepatitis b infection long before they are forced to make the decision about the vaccine.
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(1) Hyams, K.C. Risks of chronicity following acute hepatitis B virus infection: A review. Clin. Infect. Dis. 20, 992-1000. 1995.
(2) Acute hepatitis B infection and hepatitis B surface antigen positivity reported in the Department of Veterans Affairs: Occurrence in a population seeking medical assistance.
(3) Ibid. Hyams, K.C. (1995)
(4) Protection against viral hepatitis. Recommendations of the Immunization Practices Advisory Committee (ACIP). MMWR 1990 Feb 9;39(RR02):1-26.
