Measles; Rubella; Tetanus; Vaccinations; Whooping cough
About 2 billion people have been infected with the hepatitis B virus (HBV) worldwide, and each year 1 million people die, mostly due to cirrhosis and liver cancers that develop in the chronic form of this disease. In the U.S., about 1.25 million people have chronic hepatitis B.
Pregnant women with hepatitis B can transmit the virus to their babies. Even if they are not infected at birth, unvaccinated children of infected mothers run a 60% risk of developing hepatitis B before age 5. Although hepatitis B infections have dropped 95% since routine immunization began in the early 1990s, there are still children who aren't immunized, and the disease persists. Universal vaccination against this disease during childhood is very important.
Several inactivated virus vaccines, including Recombivax HB, GenHevac B, Hepagene, and Engerix-B, can prevent hepatitis B. Twinrix is a vaccine against both hepatitis A and B. They are safe, even for infants and children. Vaccination programs are proving to reduce the risk for liver cancer.
Hepatitis B Vaccine for Early Childhood. Experts now recommend that all infants and children not previously vaccinated be immunized by the time they reach seventh grade. Typical schedules for hepatitis B vaccinations in childhood are as follows:
Hepatitis B vaccine protection may wane over time. According to a 2007 study, 40% of adolescents who had received a first dose of the vaccine as newborns had declining immunity to the disease by age 14. As of now, routine booster shots are not recommended because more research is needed on the subject. Booster shots may be recommended for those at risk, such as from sexual exposure.
Hepatitis B Vaccine for Adults. The following adults are at very high risk and should be vaccinated:
Other people at risk who would benefit from vaccinations include:
The regimen in adults is typically 3 doses given over 6 months. One study reported that older adults would benefit from a fourth dose without incurring serious side effects. People who abuse alcohol may need higher doses.
A small percentage of people do not develop immunity, even after a vaccine has been given repeatedly. A more potent vaccine is proving to be effective for these people; it loses its effect after 5 years in about one-third of those who receive it.
Soreness. Soreness at the injection site is the most common side effect.
Nerve Inflammation. There have been reports of nerve inflammation after vaccinations for hepatitis B, and some questions about multiple sclerosis. However, studies and reviews have found no real evidence linking the vaccine to a number of disorders.
Due to even the small theoretical risk of nerve damage in infants, some groups oppose the vaccination in children who are not in high-risk groups. However, this risk must be balanced against the significant reduction in chronic hepatitis and liver cancer cases due to this vaccine, especially around the world. [For more information see In-Depth Report #59: Hepatitis.]
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