Newborn & Infant Pregnancy & Birth Thrive

Hepatitis B Vaccine – The First in a Long Line

bottle of medicine and syringe
Written by Jessika Firmage

Congratulations! You have finally made it through 9 months of pregnancy, labor, and delivery as they place that bundle of sweetness in your arms for the first time. Looking down into your baby’s beautiful eyes, you feel sheer ecstasy wash over you as you gaze at him in awe and wonder. You count his fingers and toes. You run your hand through his downy hair. You kiss his button nose. Perfection. He’s just as you imagined that he would be. And then they interrupt your entrance into motherhood by asking if you are ready for him to get his shots.

Yes, babies born in the United States typically start their vaccination schedule with the Hep B vaccine on the day of birth or before they are discharged from the hospital. Papers are brought in for you to sign, people get pushy, and you feel overwhelmed.

With your hormones already in the overactive, borderline crazy zone, your emotions start to build and anxiety sets in. Is it really necessary for your baby to get a Hep B vaccination so soon, you wonder. What is Hep B anyway and is your baby at risk for contracting it? What should you know before you sign those papers? Now is an excellent time to start researching and collecting the information you need to make an informed decision so you can skip the anxiety on the big day.

What is Hepatitis B?

 Hep B is a virus that infects the exposed person’s liver. Most adults who get Hep B are ill for varying time periods and recover without intervention. A small percentage of infected adults will develop chronic Hep B which is long lasting and can lead to liver damage, failure, or cancer if not carefully managed. Babies who get the disease often do not show symptoms for a long period of time, possibly even years, but are more likely to develop chronic Hep B as the symptoms do begin to manifest. As a baby grows, with age they have less of a chance of getting chronic Hep B if they are exposed later in life than as an infant. For instance, children who are exposed to Hep B have a lesser chance of developing chronic Hep B than does a baby, and so on until the chances of developing chronic Hep B drop drastically in the teen years and adulthood.

How is Hepatitis B transmitted?

 Hep B is predominantly a sexually transmitted disease (STD), but it can also be transmitted through the sharing of dirty needles from an infected person. In addition, a Hep B positive mom can pass the virus on to her baby during delivery. Rarely, someone may be exposed to the disease from a blood transfusion, but because blood donations are screened in the United States this is not a very common method of exposure to the disease in this country. According to the Hepatitis B Foundation almost 100,000 people in the U.S. contract this disease every year. Are children really at such a risk for a STD that they must all receive this vaccination immediately at birth?

In 1982, when the Hep B vaccine was first introduced, it was mainly targeted towards homosexuals, illicit drug users, and healthcare providers – categories considered “high risk” for Hep B (See the first table at the bottom ofthis CDC MMWR report for a timelineof the history of the Hep B vaccine.) But they were having trouble getting those in the high risk categories to take the vaccine. So, finally in 1991 the CDC began to recommend that all infants get the Hep B vaccine at birth. To recommend that all infants indiscriminately receive a vaccine for an STD when only the infants born to Hep B positive mothers are in the high risk category — because no infants participate in the activities that make them most vulnerable to Hep B exposure (sexual relations and dirty needles) — is an interesting proposition. Even the CDC makes it clear in this MMWR report under the “Other counseling messages” subhead that Hep B “is not spread by breastfeeding, kissing, hugging, coughing, ingesting food or water, sharing eating utensils or drinking glasses, or casual touching.” And infected persons “should not be excluded from school, play, child care, work, or other settings…” Again, this begs the question of why must all infants be given a vaccine for a sexually transmitted disease that is not spread by casual contact?

According to the chart at the bottom of this CDC MMWR report, from 1986 – 2000, less than 1 in 100,000 kids ages 1 – 9 acquired Hep B. This is the data that documents how many ac- tual cases of Hep B in children there were at the time the CDC decided to start recommending this vaccine for all newborns. Using the U.S. Census Bureau’s numbers, there were about 36 million children in this age group for this time period. [Sears, Rob- ert, MD. “The Vaccine Book.” Little, Brown and Company (2007): pg 51.Print)] This figures to 360 or less cases of Hep B a year in children before the vaccine was mandated for all newborns. A number that would allow for the babies that became infected by transmission from their Hep B positive mothers at birth, but also in line for what you would expect of a disease that is most commonly transmitted through actions babies and children are not yet performing. By the CDC’s own official documentation, we must conclude that Hep B in childhood, while it is serious, is a rare event almost exclusively connected to individual birth circumstances.

Is the Hep B vaccine 100% safe?

 “What’s the big deal?” you might ask. Why not just give the vaccine to your newborn “just in case” even though it’s documented that the incidents of Hep B occurring during infancy and childhood are naturally low in the United States. What must be taken into account is that all vaccines do carry risks. They are the same as any other drug you see advertised on TV with a long list of possible side effects read off in supersonic-speed monologue at the end of the drug commercial. Vaccines come with their own long list of possible side effects of which you are not usually informed by your healthcare provider. Your doctor will most likely provide you with a piece of paper about vaccines that basically tells you they are “safe and effective.” However, it is the vaccine insert that comes with each and every vaccine vial–and is usually thrown away by the healthcare staff–that will provide you the detailed list of possible adverse reactions for that particular vaccine. You can either ask your doctor for the “vaccine insert” to take home and read for yourself, or you can find all the vaccine inserts hereif you know the brand of vaccine that your doctor’s office uses for each shot.

The Hep B vaccine is a series given in three separate doses. Typically, the first dose is given at birth. The second is given at the first month well-check visit (or sometimes delayed to the second month well-check visit), and the last is given at the 6 months well-check visit. Some people have an issue with the trace amount of formaldehyde used in the vaccine, that while toxic and a recognized human carcinogen, is assumed to be insignificant because of the small amount that is used. Others have a problem with the aluminum adjuvant found in the Hep B vaccine since aluminum  is a known neurotoxin. An adjuvant is a substance that stimulates the body’s immune response. There are 250 micrograms of aluminum found in the Hep B vaccine. Depending on what vaccine combinations and the brands of those vaccines a baby receives (a baby can be given as many as 5 – 7 different vaccines at one appointment), that baby could easily receive well over 1000 micrograms of injected aluminum at one time. According to Dr. Sears, “When ababy gets the first big round of shotsat 2 months, the total dose of aluminum can vary from 295 micrograms(if a non-aluminum HIB and the lowest aluminum brand of DTaP  is used) to a whopping 1225 micrograms if the highest aluminum brands are used and Hep B vaccine is also given.” The possibility of this high dose exposure to injected aluminum exists at all the major vaccination milestones. Often proponents of vaccine safety will argue that we ingest more aluminum routinely than what is in avaccine. While this is true, the body handles ingested aluminum quite differently than injected aluminum. Only about 1% of ingested aluminum enters the bloodstream which then must be filtered out by the kidneys, and for the most part the other 99% is harmlesslypassed out of the body through the feces as waste never even entering the bloodstream. This is true for aluminum acquired through foods, water, or even other medicines that are taken into the body orally. Only a tiny amount is actually absorbed into the bloodstream through thisavenue of entrance into the body.

However, with injected aluminum, which bypasses the gut system that so effectively handles aluminum ingested, virtually all of aluminum injected into the body eventually enters the bloodstream forcing the kidneys of the newborn to have to filter it all out. There have been many independent studies that demonstrate that injected aluminum from vaccines can possibly have a negative impact on a child’s development. Here and here and here are just a few. If you choose to give your baby the Hep B vaccine, he will get the trace amount of formaldehyde and the 250 micrograms of aluminum in each of the three separate Hep B shots at three separate well-check visits, along with the other ingredients from other shots given at those same visits.

To vaccinate your newborn with the Hep B vaccine, or not, is a choice that only you can make for your child. Knowing the history of the vaccine, the risks of the disease, and the risks of the vaccine itself is all very important information necessary for making a truly informed decision for the health of your child. While Hep B is a serious disease for infants, it is also very rare for infants to acquire this STD outside of specific birthing factors. No one should dictate your choices to you for the health care of your child and family because no one knows your individual needs better than you. Talk to your doctor about vaccines, but also take the time to educate yourself on the risks that come with those vaccines which the manufacturers have detailed in their vaccine inserts. Don’t leave this decision to chance. It’s the first day of your baby’s whole life, make it a good one!

About the author

Jessika Firmage