The birth of my son was an event that I can recall very vividly after almost two years. That moment was a process for mother, husband and baby (more so for mom) but it’s also a moment filled with emotions so strong, I don’t care who you are, it will move you to tears. You think you know what that moment will feel like, but you have no idea until it happens how powerful it is. Immediately my focus narrowed: My wife, my son, the only two people in the world. The doctors and nurses all seemed like background players. Moving from the birth to being invited to witness my son’s first bath and examination, the doctors and nurses kept me fully informed, but it felt like they weren’t really there. What are his APGAR scores, yes we had a name picked out, yes he’ll be getting the vitamin K shot, the Hepatitis B vaccination … what what?! Record scratch, I snapped out of my haze. Isn’t that an STD? Why would you give that shot to my newborn son?
This threw me for a curve. I’m a microbiologist and my years of education have me firmly on the side of science when it comes to vaccination, but STDs and Hepatitis had never been my area of interest. I knew that my wife and I were committed to having our son vaccinated to ensure that he would be protected from potentially fatal diseases and we wanted the same for family we knew would have a lot of contact with him. Speaking personally, not vaccinating my son would run against my commitment to the principles of public health, but why Hepatitis B and why to a newborn? After a beat I asked the nurse to explain why she wanted to give him a vaccine for an STD. She was helpful and explained the reasoning to me and it made sense. I gave the nurse permission to give him the vaccination.
Once our families left and after the adrenaline rush wore off I logged into my college’s library remotely and looked into why newborns are given the Hep B vaccination. In order to answer this question, I had to first answer what exactly is Hepatitis B?
Hepatitis B (Hep B) is one of a family of hepatitis virus that attacks the liver of those infected. The liver is responsible for “cleaning” your blood, converting the nutrients in our food, turning fat into energy and excreting bile, which helps with digestion. You can live without an appendix or a gallbladder, but if your liver fails you’re in big trouble. While your liver can repair itself, if the damage is sustained it can become permanent.
With most diseases or chronic conditions there are usually symptoms that alert the person that something’s not right. With Hepatitis B, there usually aren’t symptoms until the damage is permanent. In infants the symptoms can be non-specific.
In the United States, Hepatitis A, B and C are considered endemic (that means it’s consistently found in certain populations). Hep B is a preventable infection with a vaccination, but there is no cure for the viral infection.
Hepatitis B is considered a sexually transmitted disease (STD) by the Centers for Disease Control and Prevention. STDs are also called Sexually Transmitted Infections (STIs) and if you’re old school, Venereal Diseases (VD). Like I did, most people think that STDs are only transmitted through sexual contact, but that’s not true. To be classified as an STD the primary method of transmission of the disease needs to be through sexual contact, but it isn’t necessarily the only way. Yes, you can get it by sharing drug paraphernalia but Hep B is much more opportunistic than other STDs. It’s often transmitted unknowingly in families by sharing toothbrushes or razors, or through contact with open cuts or sores and other bodily fluids. In about 30% of cases we can’t figure out how the person got it. It can also be transmitted from mother to child during birth. About 25% of adults with Hepatitis B acquired it at birth or in their early childhood. A mother with Hepatitis B has a 30% chance of passing it along to her child during birth, and of those who are exposed, 90% will develop a chronic infection. Babies and very young children are very susceptible to diseases like Hep B because their immune systems are still developing and cannot fight off the infection as readily.
So why can’t we just give the Hep B vaccine to the babies of mothers who have it? Like I said before, people usually don’t know they’re infected with Hep B until the damage is permanent. There is a test for Hep B, but it’s not always reliable depending on when the test was done compared to when the person was exposed and how far along the infection is.
So why vaccinate all newborns? If a mother is infected, administration of the vaccine to her baby within 12 hours after birth has been shown to be 95% effective in preventing infection. Because there is no cure for Hep B and the best way to stop it is to prevent it. For those reasons the American Academy of Pediatrics, American Academy of Family Physicians, the American College of Obstetricians and Gynecologists and the Centers for Disease Control all recommend that newborns be vaccinated before hospital discharge.
As a parent, I know that there are real risks inherent in vaccinating. I know that for the majority of people the small risk the vaccine poses outweighs the larger risk of infection with the disease. After looking into Hepatitis B and how endemic it is, I knew my wife and I had made the right decision for our son. Administering the vaccine early makes sense and provided me with additional peace of mind that my son will be protected. That makes my job as a parent so much easier with one less thing to think about. Now that he’s a toddler and it’s fall, I’m hoping someone can get working on that vaccine against the common cold!