Protecting Your Baby Against Hepatitis B Guide
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Are Hepatitis B Virus Infections Easily Avoided
Large quantities of hepatitis B virus are present in the blood of people with hepatitis B in fact, as many as one billion infectious viruses can be found in a milliliter of blood from an infected individual. Therefore, hepatitis B virus is transmitted in the blood of infected individuals during activities that could result in exposure to blood, such as intravenous drug use, tattooing, or sex with people who are infected. However, it is also possible to catch hepatitis B virus through more casual contact, such as sharing washcloths, toothbrushes or razors. In each of these cases, unseen amounts of blood can contain enough viral particles to cause infection. In addition, because many people who are infected don’t know that they are infected, it is very hard to avoid the chance of getting infected with hepatitis B virus.
When Kids Get The Meningitis Vaccine
There are two types of meningococcal vaccines available that help protect against different strains of meningococcal disease. According to the CDC, all 11- to 12-year-olds should get a MenACWY vaccine, followed by a booster dose at 16.
Meningitis Vaccine Schedule:
- First Dose: Between 11 and 12 years old
- Second Dose: 16 years old
Teens between the ages of 16 and 18 may also receive a serogroup B meningococcal vaccine, dubbed MenB. Your child may get both types of vaccines at the same visit, but in different arms.
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Immunisation Against Hepatitis B For People At Risk
In Victoria free hepatitis B vaccine is provided for people who are at increased risk, including:
- Men who have sex with men.
- People living with HIV.
- People living with hepatitis C.
- Prisoners.
- People no longer in a custodial setting who commenced, but did not complete, a free vaccine course while in custody.
- Aboriginal and Torres Strait Islander people.
- People born in priority hepatitis B endemic countries who arrived in Australia in the last 10 years priority countries include China, Philippines, Malaysia, Vietnam, Afghanistan, Thailand, South Korea, Myanmar , Indonesia, Singapore, Hong Kong, Taiwan and Cambodia.
- Vulnerable citizens people who have experienced hardship that prevented them from accessing the vaccine earlier. Vulnerable citizens are vaccinated based on an individual assessment by an immunisation provider.
Immunisation is also recommended, but not free, for people who are at increased risk including:
If you think you have been exposed to hepatitis B, see a doctor immediately. Your doctor can give you treatment that, in some instances, can greatly reduce your risk of infection with hepatitis B.
Remember that being immunised against hepatitis B does not protect you against HIV, hepatitis C or other diseases spread by blood or bodily fluids. It is important that you take precautions to make sure you are not exposed to these diseases.
Benefits Of Hepatitis B Vaccine
- Provides a safety net to prevent perinatal infection among infants who are born to HBsAg-positive mothers who have not been identified
- Protects infants at risk for infection after the perinatal period
- Provides higher rates of on-time completion of the hepatitis B vaccine series for infants who get the birth dose of the vaccine
- Reduces the risk that a child could get hepatitis B later in childhood
Most importantly, young children often have no symptoms when they develop hepatitis B infections, but they are still likely to develop problems with chronic hepatitis. In fact, 90% of children who develop hepatitis before they are 12 months old will develop chronic hepatitis B.
What’s more, there is no cure for chronic hepatitis B and there are very few reliable treatments. For this reason, vaccinating babies against the infection has become a routine part of a newborn’s hospital care, just like checking their hearing or listening to their heart.
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Who Should Get The Hepatitis B Vaccine
Any child up to 18 years of age who did not get the vaccine or all of the needed doses should get the vaccine.
- Your adolescent should get the vaccine if:
- He or she gets a stick from an infected needle, including for illegal drugs and for procedures such as tattooing
- He or she has unprotected sex with an infected person, sex with more than one partner, or is a male who has sex with males
- She is pregnant or breastfeeding and is at risk for hepatitis B
Who Should Receive The Hepatitis B Vaccine
For most people, the hepatitis B vaccine is safe and effective. About 90% of people who receive three vaccine doses are protected against hepatitis B for over 30 years.
The CDC’s Advisory Committee on Immunization Practices recommends the hepatitis B vaccine for the following groups:
- All babies, starting just after birth
- Children and adolescents under 19 years old
- Adults ages 1959 who have not previously completed vaccination
- Adults ages 60 and over with a high risk of contracting HBV
Adults ages 60 and over who do not have any hepatitis B risk factors can receive the hepatitis B vaccine, but it is optional.
Hepatitis B spreads when the bodily fluids of an infected person enter another person’s body. Sexual contact is one way it can be spread. A person with HBV can spread it to their baby during childbirth. Other ways in which HBV may be transmitted include:
- Sharing medical equipment, whether at home or in a hospital setting, with a person who has an HBV infection
- Sharing syringes with a person who has hepatitis B, such as during injection drug use or at-home piercing or tattooing
- Sharing personal items, such as razors or toothbrushes, with someone who has hepatitis B
- Coming into contact with the sores or blood of a person who has hepatitis B
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Accelerated Us Children And Adult Hepatitis B Vaccine Schedules
*Please note that the first dose should be given as soon as possible. Additional doses require minimum time intervals between doses in order for the vaccine to be effective.
In some instances, it may be necessary to vaccinate within a short period of time to ensure protection before travel. There are accelerated schedules to provide the highest level of protection over a short period of time. Individuals who need an accelerated schedule must have a booster dose at 1 year to ensure long-term protection. Note that the 2-dose Heplisav-B vaccine will also ensure maximum protection over a 1-month period without the need for a booster dose at 1 year.
4-Dose Vaccine Series for Children and Adults
Engerix-B is a 3-dose vaccine that can be given on an accelerated, four-dose schedule, with 3 shots administered within 2 months, and a booster dose at 1 year to provide maximum long-term protection.
4-Dose Combination Hepatitis A and B Vaccine Series
Twinrix is a 4-dose vaccine that can be given on an accelerated schedule to provide protection against hepatitis A and B. Three doses are administered within 1 month, followed by a booster shot at 1 year. This is a common choice of vaccine for those travelling on short-notice outside the U.S. It is important to complete the booster dose at 1 year, to ensure long-term protection.
2-Dose Vaccine Series
Vaccine Schedule For Preemies
Parents of premature babies may be concerned that their newborns are simply too fragile to adhere to the recommended childhood vaccination schedule. However, its not only perfectly safe for preemie to get their shots on timeits recommended. After all, if your preterm baby gets any of the infections that vaccines can prevent, their chance of suffering disease-related problems skyrockets. The one exception: If your baby weighs less than 4 pounds, 6 ounces , the AAP recommends waiting to vaccinate against hepatitis B until your little ones 1-month checkupor at the time of dischargewhichever comes first.
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Why Is This Vaccination So Important
When an adult contracts Hep B, they may become unwell but in most cases their immune systems eventually get rid of the virus. In infants, the reverse is true. While it is uncommon for infected babies to become unwell in the short term, they usually become chronic carriers of the infection. This means that they never clear the virus from their bodies. Being a chronic carrier has some important health consequences. About a quarter of people who are chronic carriers develop cirrhosis of the liver which may result in liver failure, cancer of the liver and death. Currently, in Australia, the most common reason for needing a liver transplant is cirrhosis or cancer caused by viral hepatitis.
In addition, people who are chronic carriers may pass the infection on to someone else, including any children they may have.
Facts About Hepatitis B
- Two billion people, or one in three, have been infected with hepatitis B worldwide. Of these, almost 300 million live with chronic hepatitis B. This means about 1 of every 26 people throughout the world are living with a chronic hepatitis B infection.
- Each year about 900,000 people die from hepatitis B worldwide, and about 2,000 of these deaths occur in the United States.
- Hepatitis B is transmitted through blood and is 100 times more infectious than HIV. An estimated one billion infectious viruses are in one-fifth of a teaspoon of blood of an infected person, so exposure to even a very small amount, such as on a shared toothbrush, can cause infection.
- Hepatitis B is sometimes referred to as the silent epidemic because most people who are infected do not experience any symptoms.
- Liver cancer accounted for about 5% of cancer deaths in the U.S. during 2020.
- Almost half of liver cancers are caused by chronic infection with hepatitis B.
- The World Health Organization recommends the inclusion of hepatitis B vaccine in immunization programs of all countries in 2019, more than 8 of 10 infants born throughout the world received three doses of hepatitis B vaccine.
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When Kids Get The Hpv Vaccine
The CDC recommends 11- to 12-year-olds get their two-dose HPV vaccine 6 to 12 months apart. However, the vaccine can be started at 9 years old. For kids 14 and under, two doses are the norm, but for those between 15 and 26 years, three doses of HPV vaccine are needed.
HPV Vaccine Schedule:
- First Dose: Between 11 and 12 years old, but okay as young as 9
- Second Dose: 6 to 12 months after initial dose
- Third Dose: Only for ages 15 to 26 years old. If your child is over 15, their second dose should be two months after the initial shotand the third dose needs to happen six months after their first dose.
Testing Your Baby For Infection
Each year, a very small number of babies may develop infection so your baby will be offered a blood test when they are 1 years old. This is to check that the course of vaccines have prevented them from developing hepatitis B.
There are 2 ways that this may be done and your GP, health visitor or practice nurse will advise you which test your baby will have:
If they do have the infection, they will be referred to a specialist for treatment to reduce their risk of developingserious liver disease.
If a young infant is infected, they are more likely to develop long lasting infection without any signs or symptoms of infection. Even if your baby has no signs or symptoms of infection they should still have the blood test.
Infection can be prevented in 90% of cases if the first dose of vaccine is given at birth and the full course of vaccines is completed on time.
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Rationale For The Birth Dose
Rationale for the birth dose
The rationale for the birth dose for all newborn infants is to prevent:1
- vertical transmission from a mother with chronic hepatitis B, recognising that there may be errors or delays in maternal testing, reporting, communication or appropriate response
- horizontal transmission to the infant in the first months of life from people with chronic hepatitis B who are household or other close contacts
Newborns should receive the birth dose as soon as they are medically stable, and preferably within 24 hours of birth, but the vaccine can be given within the first 7 days of life. Every effort should be made to give the vaccine before the baby is discharged from the obstetric hospital or delivery unit.
When To Delay Vaccinating
Although the Hepatitis B Foundation stresses that parents should not voluntarily delay vaccinating their babies against hepatitis B, there are situations in which doctors may choose to delay the vaccination.
For instance, sometimes the hepatitis B vaccination is delayed if a baby is premature, has a low birth weight, or is medically challenged.
The CDC’s report, Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices, says that all healthy newborns who weigh more than 4.4 pounds should receive the hepatitis B vaccination.
Still, parents always have the option to refuse a vaccination if they want to. But the risks associated with a hepatitis B infection far outweigh the risks of the vaccine.
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When Babies Get The Flu Vaccine
Once the vaccine is available for the season, children can begin getting their annual flu shot at 6 months old. Some children will need two shots to be fully protected. Flu vaccine effectiveness varies from year to year, depending on the strain of the virus thats circulating. But generally speaking, flu vaccine effectiveness hovers between 40 and 60% in the U.S.
Flu Vaccine Schedule:
- First Dose: Most children will only need one dose, including kids older than 9 and kids who are younger than 9 but have previously received at least two doses of the flu vaccine .
- Second Dose: Children younger than 9 who are getting the flu vaccine for the first time need two shots at least one month apart.
Remember, the influenza viruses change yearly, so all children 6 months and older need a flu shot every year. Also, once your child is 2 years old, the nasal spray vaccine might be an option.
Benefits Of The Hepatitis B Vaccine
The main benefit of the vaccine is its effectiveness. The AAP says that if a baby receives the first dose within 24 hours of delivery, the vaccine is 7595% effective in preventing hepatitis B transmission from parent to infant.
Additionally, if the newborn also receives the medication HBIG at the correct time with a series of follow-up vaccines, the AAP estimates that the infection rate drops to 0.71.1%.
Therefore, a baby needs to complete the full series of hepatitis B vaccines for the best possible protection.
Research indicates that hepatitis B vaccines are a safe and effective way to prevent hepatitis B infections.
According to the CDC , the vaccine is very safe, and the full series of the vaccine provides the highest possible level of protection from a hepatitis B infection.
Vaccines are subject to constant safety monitoring both during production and once doctors begin to administer them to people. Any signs of a potentially dangerous response to a vaccine would result in immediate recall, meaning they are generally very safe.
While many people misunderstand or misstate the dangers of some aspects of vaccination, there are still possibly severe conditions that doctors may associate with hepatitis B immunizations.
A discusses these possible rare complications. However, it is important to note that these results do not mean that the vaccination causes these conditions instead, there may be an association between them.
Possible conditions include:
- hives
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Rare Side Effects After Immunisation
There is a very rare risk of a serious allergic reaction to any vaccine. This is why you are advised to stay at the clinic or medical surgery for at least 15 minutes following immunisation, in case further treatment is required.
If you think your child may be having a serious allergic reaction and you are no longer at the clinic where they were immunised, take them immediately to your doctor or to the nearest hospital, or call 000 for an ambulance.
Another rare side effect is the hypotonic-hyporesponsive episode . If they are experiencing HHE, a baby may be:
- pale
- limp
- unresponsive.
This may occur from one to 48 hours following vaccination. The whole episode may last from a few minutes to 36 hours.
If you think your child may be having an HHE episode, take them immediately to your doctor or to the nearest hospital.
Follow-up of children with HHE shows no long-term neurological or other side effects.