Re: Hepatitis B immunization

[Jeff Utz]

"Astromum" > wrote in message
...
> Circe wrote:
> >
> > The theory is that, although infants are seldom at risk for HepB, it is
> > difficult to get teenagers back for immunizations and, therefore, it is
> > better to immunize at birth. In the US, Hep B is seen as being a disease
for
> > which all sexually active people are at risk, and since today's infants
will
> > presumably be sexually active at some point in their lives, the
assumption
> > is that it is better to vaccinate them now than risk the possibility
that
> > they won't get vaccinated later in life when they really need it.
>
> That's weird: when I got my shots back in Europe, I was told I needed
> an 'update' every ten years, or the vaccine would no longer be effective.
> Perhaps it depends on the type of vaccine they use. I'll be sure to ask
> our ped about this too. Thanks!

The US Centers for Disease Control and Prevention and others carefully watch
the immunity of people who were vaccinated against Hep. B many years ago.
There is no way to tell if immunity against hep. B will last 20 years until
the shots have been around 20 years (I think they have been around for about
15 years, but there were other hep. B vaccines available before that).

Jeff
> --
> -- Ilse
> mom to Olaf (07/15/2002)
> TTC #2
> "What's the use of brains if you are a girl?"
> Aletta Jacobs, first Dutch woman to receive a PhD
>

[Marie]

They wanted to catch the druggies and homosexuals early (high-risk groups)
so decided to vaccinate newborns to make sure if they grew up to participate
in a risky behaviour they'd be covered. That is why we choose not to
vaccinate for hep. b
Marie

Astromum wrote in message >...
>I was wondering what is the reasoning behind the hep-B immunizations
>for newborns in the US. In the Netherlands hepatitis immunizations are
>only given to people in certain 'risky' professions, or people that
>travel to risk areas. I googled the subject and found only schemes,
>but no real explanation. Are 'merkins more at risk for hep-B? And why
>not immunize for hepatitis A?
>
>--
>-- Ilse
>mom to Olaf (07/15/2002)
>TTC #2
>"What's the use of brains if you are a girl?"
>Aletta Jacobs, first Dutch woman to receive a PhD
>

[H Schinske]

Marie ) wrote:

>They wanted to catch the druggies and homosexuals early (high-risk groups)
>so decided to vaccinate newborns to make sure if they grew up to participate
>in a risky behaviour they'd be covered. That is why we choose not to
>vaccinate for hep. b

And that is one reason why we did choose to. Even I know an awful lot of people
who have made risky choices with regards to drugs and sexual behaviors. Many of
them have been able to change those behaviors and lead exemplary lives ... but
only because they were lucky enough not to catch anything that killed them
straight off. I figure it's a bit of a safety net. I don't want my kids
engaging in those behaviors to begin with, and I'll do everything I can to
prevent it, but I sure as heck want them to have a second chance out there if
they need it.

Many totally innocent spouses have caught stuff due to the other spouse's
behavior, too.

--Helen

[Phoebe & Allyson]

Marie wrote:

> They wanted to catch the druggies and homosexuals early (high-risk groups)

Actually, half of those homosexuals are at a lower risk of
STDs, including Hep B and cervical cancer, than straight
folks are. So you're betting your sons will grow up
straight and your daughters will be lesbians, right?

Phoebe ;)

[CBI]

"Marie" > wrote in message
...
> They wanted to catch the druggies and homosexuals early (high-risk groups)
> so decided to vaccinate newborns to make sure if they grew up to
participate
> in a risky behaviour they'd be covered. That is why we choose not to
> vaccinate for hep. b
> Marie

No parent ever thinks their darling child will do drugs or have sex at an
early age. Yet, it happens. Must be all those OTHER kids.

Besides, you forget about the kids who get it during childhood and from no
identified source. We don't know where it comes from in these cases. It is
possible that kids salivate and bleed on each other enough to pass it.

Now for the truly loaded question - what do you see as the downside to
giving it?

--
CBI

[Marie]

Phoebe & Allyson wrote in message >...
>Actually, half of those homosexuals are at a lower risk of
>STDs, including Hep B and cervical cancer, than straight
>folks are. So you're betting your sons will grow up
>straight and your daughters will be lesbians, right?


There's the government for you. They decide what's risky, I suppose.
I don't really know much about homosexuals and risk of diseases, I always
thought it would be the same as heterosexuals...dependant on protection and
promiscuity.
Marie

[Marie]

H Schinske wrote in message
>...
>And that is one reason why we did choose to. Even I know an awful lot of
people
>who have made risky choices with regards to drugs and sexual behaviors.
Many of
>them have been able to change those behaviors and lead exemplary lives ...
but
>only because they were lucky enough not to catch anything that killed them
>straight off. I figure it's a bit of a safety net. I don't want my kids
>engaging in those behaviors to begin with, and I'll do everything I can to
>prevent it, but I sure as heck want them to have a second chance out there
if
>they need it.


I will be getting the vaccine for the kids in the pre-teen years at some
point, I just didn't want to do it anymore when the kids were babies.
Marie

[Marie]

CBI > wrote in message ...
>No parent ever thinks their darling child will do drugs or have sex at an
>early age. Yet, it happens. Must be all those OTHER kids.


Well I certainly hope my newborns won't be having sex and doing drugs.
Possibly when they are older (which is why I'll get it for them later), but
I hope not!

>Besides, you forget about the kids who get it during childhood and from
no>identified source. We don't know where it comes from in these cases. It
is>possible that kids salivate and bleed on each other enough to pass it.


Honestly I haven't given much thought to that, as my kids aren't in daycare
(and the one who was did get the hepb vaccine as a baby b/c I did what I was
told way back then), and I have never come across a situation where I've
seen children salivate and bleed on each other, besides my daughters on each
other.

>Now for the truly loaded question - what do you see as the downside to
>giving it?


The lack of necessity, imo. Things put into the body that shouldn't be
there, especially at such a tender age. Babies get enough chemicals.
Marie

[blacksalt]

Jeff Utz wrote:

> And people who have sex with other people, like teenages.
>
> And people born to these people. Just about all babies.

And healthcare workers. Hep B is much more transmittable via needle
stick than HIV.
blacksalt
eagerly awaiting a hep C vaccine

[Jeff Utz]

"Marie" > wrote in message
...
> They wanted to catch the druggies and homosexuals early (high-risk groups)

And people who have sex with other people, like teenages.

And people born to these people. Just about all babies.

> so decided to vaccinate newborns to make sure if they grew up to
participate
> in a risky behaviour they'd be covered. That is why we choose not to
> vaccinate for hep. b

And the way you know that your kid won't have sex when (s)he is a teen,
isn't gay, won't get blood transfusions or won't be a drug user is what?

Jeff

> Marie
>
> Astromum wrote in message >...
> >I was wondering what is the reasoning behind the hep-B immunizations
> >for newborns in the US. In the Netherlands hepatitis immunizations are
> >only given to people in certain 'risky' professions, or people that
> >travel to risk areas. I googled the subject and found only schemes,
> >but no real explanation. Are 'merkins more at risk for hep-B? And why
> >not immunize for hepatitis A?
> >
> >--
> >-- Ilse
> >mom to Olaf (07/15/2002)
> >TTC #2
> >"What's the use of brains if you are a girl?"
> >Aletta Jacobs, first Dutch woman to receive a PhD
> >
>
>

[Phoebe & Allyson]

Marie wrote:

> I don't really know much about homosexuals and risk of diseases, I always
> thought it would be the same as heterosexuals...dependant on protection and
> promiscuity.

There's nothing about sexual orientation per se; it's
dependent on what you're doing and who you're doing it with.
But the average lesbian does less of it and with fewer
people than the average straight woman, straight man, or gay
man. Like any average, it doesn't tell you anything about
any specific person.

Phoebe :)

[abacus]

"Marie" > wrote in message >...
> CBI > wrote in message ...
> >Now for the truly loaded question - what do you see as the downside to
> >giving it?
>
>
> The lack of necessity, imo. Things put into the body that shouldn't be
> there, especially at such a tender age. Babies get enough chemicals.
> Marie

Makes sense to me ma'am. That's pretty much the reason I decided
against for my youngest. Child doesn't need it at that age. While I
don't know for sure whether or not the stories of fatal reaction to
the vaccine are true or not, its a risk I choose not to have my child
take until later.

[Marie]

Jeff Utz wrote in message ...
>
>"Marie" > wrote in message
...
>> They wanted to catch the druggies and homosexuals early (high-risk
groups)
>
>And people who have sex with other people, like teenages.

BUT this is about vaccinating babies, not vaccinating teens!

>And people born to these people. Just about all babies.
>
>> so decided to vaccinate newborns to make sure if they grew up to
>participate
>> in a risky behaviour they'd be covered. That is why we choose not to
>> vaccinate for hep. b
>
>And the way you know that your kid won't have sex when (s)he is a teen,
>isn't gay, won't get blood transfusions or won't be a drug user is what?


No one knows...who said they won't? Not me...(though I hope just like any
other parent mine won't do anything risky) but that doesn't mean you should
vaccinate a baby against it. Why not wait until the child is older and
stronger? Blood is supposed to be tested for these diseases, just so I
covered that point when you brought it up.
The risk isn't in not vaccinating a baby against hep B, it's in not
vaccinating the child at all at any point.
Marie

>Jeff

[Beth Kevles]

Hi -

I was curious, so went to the CDC web site to look up Hep B and why they
want to vaccinate children. (To see what I read, to to www.cdc.gov and
then look under Health Topics A-Z, then look under H for Hepatitis. The
article on why to vaccinate in childhood contained the following
paragraph. (This is a medical paper, not one specifically targeted at
the general public, by the way.) It said:

BEGIN QUOTE

Immunization with hepatitis B vaccine is the most effective means of
preventing HBV infection and its consequences. In the United States,
most infections occur among adults and adolescents (2,3). The
recommended strategy for preventing these infections has been the
selective vaccination of persons with identified risk factors
(1,2). However, this strategy has not lowered the incidence of hepatitis
B, primarily because vaccinating persons engaged in high-risk behaviors,
life-styles, or occupations before they become infected generally has
not been feasible. In addition, many infected persons have no
identifiable source for their infections and thus cannot be targeted for
vaccination (2).

END QUOTE

The article also talked about "horizontal infection", which I think
means from child to child, during the first 5 years of life.

In other words, even if your child egages in no risky behaviors, it
appears that there is still a risk of developing this chronic liver
disease.

I don't know if this changes the conversation at all; babies are clearly
at very LOW risk if their moms are uninfected.

--Beth Kevles

http://web.mit.edu/kevles/www/nomilk.html -- a page for the milk-allergic
Disclaimer: Nothing in this message should be construed as medical
advice. Please consult with your own medical practicioner.

[Sue]

My husband has a friend that he went to high school with. She lost her
virginity at 11 years old. Wow. My daughter is going to be 11 in September.
I can't imagine her going out and having sex, but then again I am sure the
mom whose daughter lost it at 11 thought the same thing. Some risky
behaviors in children are done right under our noses and some things we
might not even be aware of. It probably would have been in the best interest
of the girl if she had been vaccinated during her childhood or even earlier.
--
Sue
mom to three girls

Marie > wrote in message
...
> They wanted to catch the druggies and homosexuals early (high-risk groups)
> so decided to vaccinate newborns to make sure if they grew up to
participate
> in a risky behaviour they'd be covered. That is why we choose not to
> vaccinate for hep. b
> Marie
>
> Astromum wrote in message >...
> >I was wondering what is the reasoning behind the hep-B immunizations
> >for newborns in the US. In the Netherlands hepatitis immunizations are
> >only given to people in certain 'risky' professions, or people that
> >travel to risk areas. I googled the subject and found only schemes,
> >but no real explanation. Are 'merkins more at risk for hep-B? And why
> >not immunize for hepatitis A?
> >
> >--
> >-- Ilse
> >mom to Olaf (07/15/2002)
> >TTC #2
> >"What's the use of brains if you are a girl?"
> >Aletta Jacobs, first Dutch woman to receive a PhD
> >
>
>

[abacus]

"CBI" > wrote in message >...
> "Marie" > wrote in message
> ...
> >
> > The risk isn't in not vaccinating a baby against hep B, it's in not
> > vaccinating the child at all at any point.

> There are several risks
>
> 1) The teen might not ever come in for the vaccines. Vaccination rates
> amongst teens is notoriously low.

There are a good many years twixt newborns and teenagers. The risk of
the disease is low and if a parent chooses to vaccinate against hep B
at some point in those intervening years, I don't see that as being
either a) a problem for anyone in our society or b) a reason to
criticize their decision.

> 2) The kid might be exposed before you decide they are at risk. This can
> happen from consentual sex or drug use, accidental exposure, or abuse. The
> second two of these can happen at any age and the first often happens sooner
> than the parents would think.

These risk factors apply to adults too, but no one is suggesting that
all adults be vaccinated for Hep B because of those risk factors. The
vaccine is recommended only for adults who are in high risk
situations.

> Lastly - you talk about the kid getting stronger - upon what do you base
> this? Some diseases, like chicken pox, are much worse as the kids get older.
> In this respect there is no reason to presume that the school aged child is
> any "stronger" than the newborn infant.

Actually, what I've read indicates that the newborn infant is indeed,
less able to cope with infectious agents than older children and
adults. In fact, I thought it was relatively commonly known. I was
under the impression that many diseases are more severe and have a
greater chance of causing serious problems in those with compromised
immune systems, older individuals and BABIES (I always thought the
latter two groups were assumed to have immune systems that don't
function as well as possible). Are you saying that that isn't the
case? I thought that's why some vaccinations are recommended for
babies and older individuals but not for healthy adults. Since a baby
born to a non-infected mother is at very low risk for the disease, I
personally don't see any reason to vaccinate for Hep B until the child
is at an age where the risk of the disease is higher and their immune
system more developed.

[CBI]

"Beth Kevles" > wrote in message
...
>
> The article also talked about "horizontal infection", which I think
> means from child to child, during the first 5 years of life.

Yes.

Vertical is mother to child.


> In other words, even if your child egages in no risky behaviors, it
> appears that there is still a risk of developing this chronic liver
> disease.
>
> I don't know if this changes the conversation at all; babies are clearly
> at very LOW risk if their moms are uninfected.

Low - yes, absolutely.

Before the Hep B universal vaccination campaign there were about 18000 cases
per year in kids under 10. That means that out of the about 4 million kids
born in the US per year about 18,000 of them would get infected before ten.
The numbers then rise int he teen yrs presumably due to drugs and sex.

18/4,000 certainly is low but it is not zero. Whether this low risk warrants
this vaccine depends on the added risk of giving the vaccine early rather
than later. I don't know of any. The risk of missing the onset of sexual
activity or drug use should be added to this equation.

The added wrinkle is that the number of kids under ten getting hep B has now
fallen to a few hundred per year (in the US). Since we are not sure where
all these case came from it is not clear if this should affect one's
estimations of risk or not.

Clearly, it is good public policy if not personal policy.

--
CBI

[CBI]

"abacus" > wrote in message
m...
>
> There are a good many years twixt newborns and teenagers.

Yes, but it is not clear how long twixt newborn and having sex or doing
drugs.

> The risk of
> the disease is low

Yes, but not zero.

> and if a parent chooses to vaccinate against hep B
> at some point in those intervening years, I don't see that as being
> either a) a problem for anyone in our society or b) a reason to
> criticize their decision.

1) To be clear - Not only have I not criticized the decision - I have
allowed that it may be appropriate. What I have critisized is the reasoning
to date. All arguments presented so far that have tried to paint the
decision as a rational one based on real estimates of risk have been flawed.

2) It is not clear if the decision presents a problem to society or not. The
evidence would seem to indicate that it is possible that it does.


> These risk factors apply to adults too, but no one is suggesting that
> all adults be vaccinated for Hep B because of those risk factors. The
> vaccine is recommended only for adults who are in high risk
> situations.

The idea is that in time the fully vaccinated kids will be adults. The at
risk group is fairly young and they are not easily targetted. This is a back
handed way of doing exactly what you say we are not. Unfortunetely, the
forehanded ways have not worked.


> Actually, what I've read indicates that the newborn infant is indeed,
> less able to cope with infectious agents than older children and
> adults.

The vaccine is not an infectious agent.

--
CBI

[abacus]

"CBI" > wrote in message >...
> "abacus" > wrote in message
> m...
> >
> > There are a good many years twixt newborns and teenagers.
>
> Yes, but it is not clear how long twixt newborn and having sex or doing
> drugs.

I think it safe to say its still in the time frame of a decade, give
or take a few years.

> > The risk of
> > the disease is low
>
> Yes, but not zero.

No, it's not zero. No one said it was. The risk of having an adverse
effect to the vaccination is low but not zero as well.

> > and if a parent chooses to vaccinate against hep B
> > at some point in those intervening years, I don't see that as being
> > either a) a problem for anyone in our society or b) a reason to
> > criticize their decision.

> 1) To be clear - Not only have I not criticized the decision - I have
> allowed that it may be appropriate. What I have critisized is the reasoning
> to date. All arguments presented so far that have tried to paint the
> decision as a rational one based on real estimates of risk have been flawed.

I'm sorry, but that's a distinction I had difficulty inferring from
your previous words.

> 2) It is not clear if the decision presents a problem to society or not. The
> evidence would seem to indicate that it is possible that it does.

What evidence are you referring to here?

> > These risk factors apply to adults too, but no one is suggesting that
> > all adults be vaccinated for Hep B because of those risk factors. The
> > vaccine is recommended only for adults who are in high risk
> > situations.

> The idea is that in time the fully vaccinated kids will be adults. The at
> risk group is fairly young and they are not easily targetted. This is a back
> handed way of doing exactly what you say we are not. Unfortunetely, the
> forehanded ways have not worked.

I'm sorry, but I don't follow what you're trying to communicate here.
Are you saying that all adults *should* be vaccinated, but we are
attempting to do that through vaccinating everyone as an infant? If
that's really such a good idea, I don't understand why there isn't a
recommendation that all adults be vaccinated rathern than just the
high-risk groups?

> > Actually, what I've read indicates that the newborn infant is indeed,
> > less able to cope with infectious agents than older children and
> > adults.
>
> The vaccine is not an infectious agent.

Correct me if I'm wrong, but I though vaccines worked through
stimulating the same bodily response as the infection agent. If a
newborn's body isn't able to cope with the infectious agent the
vaccine is mimicking as well as they can when they are older, it seems
a reasonable hypothesis that their bodies aren't going to be able to
cope with vaccine as well either.

The risk of an adverse reaction may be low, but the vaccine could be
improved in the next ten years too. Perhaps the risk will be lower
then. At any rate, it shouldn't be any higher.

[Astromum]

Beth Kevles wrote:
> I was curious, so went to the CDC web site to look up Hep B and why they
> want to vaccinate children. (To see what I read, to to www.cdc.gov and
> then look under Health Topics A-Z, then look under H for Hepatitis.

Thanks Beth, that was more or less what I was trying to find, but
didn't know where to look for. I am eagerly awaiting comparison
studies between USA and European adolescents in a decade or so...

--
-- Ilse
mom to Olaf (07/15/2002)
TTC #2
"What's the use of brains if you are a girl?"
Aletta Jacobs, first Dutch woman to receive a PhD

[Ericka Kammerer]

CBI wrote:


> It is not a live virus so the child will either react or not but has no
> chance of "not coping." It has been studied and it appears the the young
> ones do react quite nicely. There is no theory to suggest that the
> successful reaction, or the unsuccessful ones, present any burden that is
> harmful in any way. In fact, the way the immune system becomes "strong" is
> by being challenged so most reasonable theories should suggest that the
> vaccines are good for the kids.


And in fact, there are several studies showing that early
vaccinations (by 2 months or so) lead to fewer immune system problems
(most notably less likelihood of atopic disease), with the theory
being that the early vaccinations exercise the immune system in
a good way so as to beneficially affect the development of T cells.

Best wishes,
Ericka

[Hillary Israeli]

In >,
Ericka Kammerer > wrote:

*CBI wrote:
*
*
*> It is not a live virus so the child will either react or not but has no
*> chance of "not coping." It has been studied and it appears the the young
*> ones do react quite nicely. There is no theory to suggest that the
*> successful reaction, or the unsuccessful ones, present any burden that is
*> harmful in any way. In fact, the way the immune system becomes "strong" is
*> by being challenged so most reasonable theories should suggest that the
*> vaccines are good for the kids.
*
*
* And in fact, there are several studies showing that early
*vaccinations (by 2 months or so) lead to fewer immune system problems
*(most notably less likelihood of atopic disease), with the theory
*being that the early vaccinations exercise the immune system in
*a good way so as to beneficially affect the development of T cells.
*

Hee hee. I just like the idea of exercising the immune system. I am
picturing lymphocytes lifting barbells and neutrophils punching punching
bags full of bacteria. hee hee hee.

--
hillary israeli vmd http://www.hillary.net
"uber vaccae in quattuor partes divisum est."
not-so-newly minted veterinarian-at-large :)

[Ericka Kammerer]

Hillary Israeli wrote:

> In >,
> Ericka Kammerer > wrote:

> * And in fact, there are several studies showing that early
> *vaccinations (by 2 months or so) lead to fewer immune system problems
> *(most notably less likelihood of atopic disease), with the theory
> *being that the early vaccinations exercise the immune system in
> *a good way so as to beneficially affect the development of T cells.
>
> Hee hee. I just like the idea of exercising the immune system. I am
> picturing lymphocytes lifting barbells and neutrophils punching punching
> bags full of bacteria. hee hee hee.


Yes, that's sort of my image too and I find it rather
amusing ;-) And really, it makes a certain amount of sense to
me as well.

Best wishes,
Ericka

[Ericka Kammerer]

abacus wrote:

> Ericka Kammerer > wrote in message >...

>> And in fact, there are several studies showing that early
>>vaccinations (by 2 months or so) lead to fewer immune system problems
>>(most notably less likelihood of atopic disease), with the theory
>>being that the early vaccinations exercise the immune system in
>>a good way so as to beneficially affect the development of T cells.
>
> Interesting, I haven't seen such studies.


It's an interesting line of research. Things aren't conclusive
yet by any means, but it's related to the "hygiene hypothesis" line of
research into atopic disease. The basic idea is that one of the factors
theorized to have led to the increased prevalence of atopic disease,
particularly in more developed areas, is that hygiene is too good,
leading to fewer childhood infections. When babies are born, they
have immature T helper cells. Fairly early in life, they begin to
differentiate into Th-1 or Th-2 types of cells. If the balance is tipped
too far towards Th-2 cells, the incidence of atopic disease is
increased. While a number of factors can influence this distribution,
certain kinds of infections are helpful in stimulating strong Th-1
responses. It is theorized that the right sort of vaccinations can
do the same--with less risk than exposing infants to serious
infections. Time does seem to be significant. If this process
doesn't start early enough, you may miss the window of opportunity
for affecting the balance of Th-1 and Th-2 cells.

From what I've read, there seems to be a mounting pile
of evidence along several streams that are supportive of these
theories. I don't think anyone suggests that this is the *only*
factor involved, but it does seem to help explain many things
and there's a plausible physiological mechanism.

Best wishes,
Ericka