Thursday, September 19, 2013

Vaccination can give birth to the end of hepatitis B

People may not realize that an infected mother can pass on the hepatitis B virus to her newborn. This is a serious disease caused by a virus that attacks the liver. According to the Centers for Disease Control and Prevention (CDC), the hepatitis B virus can cause lifelong infection, cirrhosis (scarring) of the liver, liver cancer, liver failure, and death. 

Fortunately, there’s a way to prevent transmission of the virus to newborns - vaccination at birth to prevent the perinatal transmission. Experts agree that the disease could even be eliminated by vaccinating all newborns. 

Recently, a small nonprofit called the Immunization Action Coalition (IAC) has been urging the nation’s birthing institutions to “Give birth to the end of hepatitis B,” asking them to get involved in promoting this standard of care and assuring administration of the hepatitis B vaccine shortly after birth. One way to assure the vaccine is given to newborns is for the hospital to make the vaccine birth dose part of a standard order set so it is universally administered before hospital discharge. Then, follow up in the doctor’s office or clinic with a total of 3 or 4 doses at properly spaced intervals would help more than 95% of infants, children, and adolescents develop lifelong immunity to the hepatitis B virus. It’s important for mothers to know about this and insist that their babies receive hepatitis B vaccine before they leave the hospital. If the mother is known to have the disease or her status is unknown, the vaccine should be given within 12 hours.

Despite the expert consensus, nearly one in three US newborns leaves the hospital un-vaccinated against hepatitis B, and approximately 800 US newborns become chronically infected each year because of perinatal exposure. Some doctors may decide not to give the baby the vaccine if the mother has a negative screening test, electing instead to give the vaccine after discharge. But this is risky. There can be situations where a medical error occurs, like ordering the wrong hepatitis B screening test or misinterpreting or mistranscribing hepatitis B test results. Failure to properly communicate test results to or within the hospital is also a possibility. There are also doctors who don’t notice that the mother was never tested and let it go, never getting the screening test for mom. So there is room for error - all reasons to give the vaccine at birth and the sooner the better. The hepatitis B vaccine for newborns is recommended by many professional organizations and health care agencies including the American Academy of Pediatrics and the CDC.


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