ANOTHER HepB vaccine question...

Nurses General Nursing

Published

My son is in kindergarten, and supposed to get a HepB shot when school resumes in January. My question is..WHY? Is it really important? I just don't like the idea. (Stone me, I'm not a big vaccination fan, anyway...Long story, and not the issue here)

Any input?

Thanks.

Heather

Heather,

I am pro vaccination. But there are situations when it may not be appropriate to be immunized.

Here is a vaccination resource site called the Immunization Action Coalition and the Hepatits B Coalition. http://www.immunize.org /

At this site I sepcifically recommed the Unprotected People stories page. http://www.immunize.org/stories/unprot.htm

STORY #2

Parent of child with HBV testifies about importance of hepatitis B vaccination.

If you haven't, try posting your concerns on the school nursing and pediatric page. Also discuss with the school nurse where your child will be attending school as well as your pediatrician.

Sharon,

Thanks for the link. I was just looking for info on the vaccination.

Let me qualify my post by saying that I am CERTAINLY not ANTI-vaccination. My oldest had a very bad reaction to some of his shots, as well as other people in our family. My doctor has actually said she would not recommend that our family immunize for some things, as they don't really know what caused these particular reactions. Probably some kind of antibody in the blood... Anyway, it isn't worth the risk to me!

Thanks again for the link..I will definitely check it out, because a LOT of other parents have been questioning it too. It just seemed odd to some, because the way the school is doing vaccinations doesn't make much sense. They did grade 4 last month, and kindergarten next month... The parents just want details that aren't being provided by the school!! smile.gif

Happy New Year, all!!

Heather

Hi Heather,

I formerly worked in a health department and gave vaccinations, so my info may not be 100% current.

I will speculate that your state recently mandated HBV vaccination and they are trying to "catch everyone up", which they do by mandating it for some year or years of entry into school. In my state, we started by making it an optional vaccine for infants and then we mandated in for 6th grade entry and kindergarten entry and then it gradually became a necessary vaccination for school attendance (unless your doctor releases you for medical reasons). So this weird pattern of vaccinating 4th and then K students seems like they are playing a little catch-up to get kids vaccianted.

Happily Hepatits B deaths are down significantly with vaccination. This is the truth and cdc site will reflect this. Hep B death is not a quick and easy death; it is chronic illness (that can be managed) with a risk for liver cancer and liver failure. I am a nurse and 300 health care workers per year died from Hep B at one time. Hep b is a bloodborne pathogen and is spread by direct contact with infected blood, sexual intercourse, needle sharing, etc. At one time, I had some (by now pretty old stats) that noted that risk of transmission with infected blood was 30% for HBV and something like 0.3% for HIV, so HBV is "easier" to get from a single exposure to infected blood.

The CDC's goal is to give children lifetime protection from a preventable disease that carriers considerable morbidity and mortality.

I think most parents wonder, why should I vaccinate my kid? At kindergarten, they aren't having sex, using needles etc. Surely actual risk for accidental transmission from an infected child in a playground accident with bleeding isn't too significant. To me, the main ADVANTAGE is that your child has protection from this bad disease at the moment he may practice risk behaviors. You don't have to say, "Gee, Susie, I'm worried about those friends you hang with; let's get your HBV series started." NONE of us plan that our children will engage in risk behaviors, but sometimes they do. (Including getting drunk and having sex with partners they wouldn't ordinarily choose.)

Finally, a friend of mine (a nurse) felt that the long term studies are not yet able to support that the vaccine given to an infant will give protection in young adulthood [probably because of the youth of the vaccine]. I have not read studies on this but my own hepatitis b vaccine is at least 15 years old and my titer (level of protection) is just great. Many experts feel that even a low titer does not necessarily mean that you won't have protection at exposure because of the marvelous workings of our immune system.

As pro-vaccine as I am, I am a little scandalized at how punctured our kids are between the routine baby shots, HBV, and chicken pox. It is good to ask questions. I would direct you to my favorite site for the Center for Disease Control. www.cdc.gov I would guess that they have faq's site for Hepatitis B vaccination.

Good luck.

Hi Heather,

I followed by own advice and went to the CDC site. Here is a link that will take you to a MMWR (morbidity and Mortality weekly report) supplement dealth wholly with HEp B and the vaccine.

About half way through this article is a section that talks about VACCINE EFFICACY and it talks about the longevity of vaccine--upshot is that it looks good, but they are still studying it. Here's the link. http://aepo-xdv-www.epo.cdc.gov/wonder/prevguide/m0033405/m0033405.htm

Good luck. Scientifically based decision making is rarely black or white but the bottom line for me is that I feel good having my child vaccinated against this disease, but he tolerated his vaccines readily. Clinically, people tolerated this vaccine really pretty well in my experience, but a very few people really did not like the way it made them feel.

Hi. I am a senior nursing student at the University of Minnesota and I wanted to respond to a past question, but one that has been continuing to be asked by many parents during my clinical rotation in the hospital. The question is, "Why is it important for children to get a HepB immunization?" I hope my following answer can help all parents make an informed decision when it comes to Hepatitis B.

HepB is a serious disease, that can be an acute (beginning abruptly with marked intensity and then subsiding after a relatively short period) and/or chronic (developing slowly and persisting for a long time) infection, or it can be asymptomatic, as well as, fatal (Wong, 1999). The Hepatitis B virus (HBV) can lead to cirrhosis (a chronic destructive disease of the liver), or liver cancer in adulthood, both of which, unfortunately, have no successful treatment. HBV transmission is usually through exchange of blood, or any bodily secretion or fluid, either directly through intimate contact or indirectly, such as, shared needles (Wong, 1999).

I found it interesting that younger children and adolescents are identified as a high-risk group for contracting the HBV (Wong, 1999). This identified at risk group stems from their higher risk-taking behaviors and spontaneous actions that characterize this developmental period (Wong, 1999). Most parents would find it difficult to believe that their young children may partake in these risky behaviors, but why take the chance.

The HBV immunization, consisting of three injections, is effective, safe, and widely administered. "More than an estimated 10 million adults and 2 million infants and children have been vaccinated in the United States, and at least 12 million children have been vaccinated worldwide" (http://www.immunize.org/). The most common side effects of the HBV immunization are pain at the injection site and a mild low-grade fever. "More severe and life threatening reactions are anaphylaxis (i.e. approximately one event per 600,000 vaccine doses distributed) and in rare instances can cause a life threatening hypersensitivity reaction in some people" (http://www.immunize.org/). One must remember, that the former are very rare.

Ultimately, the decision to have your child/children immunized against the HBV is up to you; however, make sure it is an informed decision. There are great sources available to help you understand the HBV, but I hope this response helps you somewhat with your decision. The following list of references helped me locate this information.

References

(http://www.immunize.org/). [2000, January 29].

Wong, D. (1999). Nursing care of infants and children. St. Louis, MI: Mosby.

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