Hepatitis B Vaccine: When To Give It? What About Vaccinated Persons Who Get An Exposure?
Back in the February 2014 edition of AAP news (www.aapnews.org) there was an article, “Should vaccinated Pediatrician receive post-exposure prophylaxis for hepatitis B?”. So this is the guidance we the pediatricians are being given, and should be the best of the best in advice. The scenario would be quite typical for most adults in the USA: the adult has previously been fully vaccinated, has not had serology tested after the vaccine series and if it has been more than 10 years since that series, the adult likely does not have measurable antibodies HBsAg showing protection against Hepatitis B, and they poke themselves with a Hep B positive needle (or imagine some other risk like sex or IV drug use sharing needles).
Key elements of the recommendations are:
Give a booster dose and if repeat titer is <10mIU/ml – repeat the 3 shot series with 2 more shots.
Test serology after completing the second series.
Test the potential exposure person to prove they have hepatitis B.
Other facts presented are:
Only 5% of those who get the series of three hepatitis B vaccines fail to mount an immune response.
Even if properly immunized, you can still be at risk of infection.
Approximately 16% of persons vaccinated in the first year of life will have detectable anti-HBs 18 years later compared to 75% of those vaccinated after 12 months age.
If you were vaccinated 9-22 years earlier and were over 1 year old when vaccinated, there is a 69-96% chance that you will respond to a single challenge dose and demonstrate antibodies >10mIU/ml.
This article sites as resource MMWR 2013;62(10):1-19 which seems to have been taken down off the Internet..
I find a disturbing pattern of inconvenient facts and information being systematically removed by the CDC.
How do we have an honest debate on the facts when the those facts that contradict CDC policy are removed from access?
This article clearly quotes statistics that make it absolutely clear that vaccinating newborns for Hepatitis B (when mom is Hep B negative) makes absolutely no sense. When the vaccine is given at this age it is not providing lasting protection and in fact it is clearly a bad idea since the time we need protection is when one is a teenager or young adult and likely to engage in risky behaviors (sex and IV drug use).
These statistics are the most compelling I have seen as to why you should NOT give the Hepatitis B vaccine to newborns and infants. Much of the rest of the world has already figured this out. Wake up AAP and CDC. The truth is out. It is your refusal to acknowledge that you have made a mistake in recommending the Hepatitis B vaccine for all newborns that makes people suspicious of all your recommendations. You would serve the country well to just put all the facts on the table, acknowledge that we tried the experiment of giving Hepatitis B to newborns, and it didn’t work out as we had hoped. The hope had been that we could have a population that was immune to Hepatitis B. That hasn’t happened. It is time to go back to vaccinating only infants at risk and everyone else in the pre-teen and early teen years.
My resource, which is listed below, is only available by subscription:
ID SNAPSHOTShould vaccinated pediatrician receive post-exposure prophylaxisfor hepatitis B?
- Cody Meissner
AAP News 2014; 35:13; doi:10.1542/aapnews.2014352-13
Copyright 2014 by the American Academy…Pediatrics February 2014 news ID SNAPSHOT 38 32.03 Should vaccinated pediatrician receive post–exposure prophylaxis forhepatitis B? H. Cody Meissner…properly but still may be susceptible to…