Why Are Babies Given Hep B at Birth

Unprotected People Reports: Hepatitis B Unprotected Babies: Hepatitis B Vaccine at Nascence Saves Lives! Click here for a fully-formatted PDF version of this study On October 17, 2001, the Advisory Committee on Immunization Practices (ACIP) voted to recommend a birth dose of hepatitis B vaccine for all U. S. infants. (Only for infants of mothers whose HBsAg test is assured to exist negative does ACIP now corroborate giving the starting time dose as late equally two months of age.) The following article is adapted from an open letter by Deborah 50. Wexler, 1000.D., to ACIP, American Academy of Pediatrics, American University of Family Physicians, American College of Obstetricians and Gynecologists, National Medical Association, and other medical professional organizations. The Immunization Activity Coalition (IAC) urges all health professionals and hospitals to protect all infants from hepatitis B virus (HBV) infection past administering the first dose of hepatitis B vaccine to every baby at nascency and no later than hospital discharge. Approximately 19,000 women with chronic hepatitis B infection give birth in the United States each twelvemonth. Ninety percent of perinatal infections can be prevented by postexposure prophylaxis given within 12 hours of birth. Tragically, many babies are exposed to HBV at nativity simply exercise not receive appropriate postexposure prophylaxis. Because thimerosal has been removed from all pediatric hepatitis B vaccines in the United states, concerns about thimerosal should no longer be an obstacle for practitioners in enacting a universal birth dose policy. Why is such a policy necessary? Following are some of the ways infants who are not vaccinated at nativity become infected: The meaning woman is tested and found to be hepatitis B surface antigen (HBsAg) positive, only her status is not communicated to the newborn nursery. The infant receives neither hepatitis B vaccine nor HBIG protection at birth. A chronically infected pregnant woman is tested but with the incorrect test, HBsAb (antibody to hepatitis B surface antigen), instead of HBsAg. This is a common mistake since these 2 test abbreviations differ by only ane letter of the alphabet. Her incorrectly ordered test result is "negative," and then her doctor believes her baby does not demand postexposure prophylaxis. The meaning woman is HBsAg positive, but her test results are misinterpreted or mistranscribed into her prenatal tape or her infant'due south nautical chart. Her baby does not receive HBIG or hepatitis B vaccine. The pregnant woman is non tested for HBsAg either prenatally or in the hospital at the fourth dimension of delivery. Her infant does not receive hepatitis B vaccine in the hospital, even though it is recommended inside 12 hours of birth for infants whose mothers' examination results are unknown. The woman is tested in early pregnancy for HBsAg and is establish to be negative. She develops HBV infection later in pregnancy, but it is not detected, fifty-fifty though information technology is recommended by CDC that high-hazard women be retested later in pregnancy. Because the infection is non clinically detected by her health care provider, her infant does not receive hepatitis B vaccine or HBIG at birth. The mother is HBsAg negative, just the infant is exposed to HBV postnatally from another family member or caregiver. This occurs in two-thirds of the cases of childhood manual. While in that location are advantages to giving the first dose at a later well-baby visit, these are advantages of administrative convenience. The master advantage of giving the showtime dose at nativity is that it saves lives. IAC recently asked hepatitis coordinators at every state health department every bit well as at city and canton CDC projects to express their views about providing hepatitis B vaccine in the hospital. Their responses contained many examples of children who were unprotected or inadequately protected due to health professionals not ordering, misordering, misinterpreting, mistranscribing, and miscommunicating the hepatitis B examination results of the children's mothers. These land coordinators' reports tell us that no matter how well wellness care providers think they are doing with HBsAg screening of all meaning women, serious mistakes continue to occur; children are unnecessarily being exposed without the benefit of postexposure prophylaxis, and at least one baby has died. In order to overcome these failures, all fifty states overwhelmingly endorse providing a nascency dose. Nosotros must vaccinate every baby in the infirmary prior to discharge regardless of the HBsAg status of the mother. For those providers who choose to utilise hepatitis B-containing combination vaccine, i.e., Comvax, they may do so. However, since this vaccine cannot be given at birth, monovalent hepatitis B vaccine must exist given at nascency and and then the hepatitis B vaccine serial can be completed with three doses of the combination vaccine. (Giving iv doses of hepatitis B vaccine has been shown to be safe in several clinical studies.) Hepatitis B vaccine is 1 of the about effective vaccines available. Studies accept shown that infants of the nigh highly infectious mothers (women who are both HBsAg and HBeAg positive) who receive postexposure prophylaxis with hepatitis B vaccine alone (without HBIG) at birth are protected in 90–95% of cases, essentially the aforementioned level of protection afforded by administering hepatitis B vaccine in addition to HBIG. Even college rates of protection with postexposure prophylaxis have been demonstrated in infants born to less infectious mothers (those who are HBsAg positive and HBeAg negative). Please read the hepatitis coordinators survey results (see the web accost in the box below), including descriptions of their experiences with failures of the electric current organization—failures that can exist largely prevented by administering hepatitis B vaccine to infants earlier they go home from the hospital. Your support for providing a nativity dose of hepatitis B vaccine to infants while even so in the hospital will protect and relieve lives that are now being put at take a chance. Here's more information about why to requite the birth dose To read the results of IAC'south survey of state health department hepatitis coordinators, visit: www.immunize.org/birthdose/survey.htm For more information near why all babies should receive the first dose of hepatitis B vaccine in the hospital, become to the Nativity Dose page of IAC's website at: world wide web.immunize.org/birthdose 10/7/02 • REPORT #45 Disclaimer: The Immunization Action Coalition (IAC) publishes Unprotected People Reports for the purpose of making them available for our readers' review. Nosotros accept non verified the content of this written report.

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Source: https://www.immunize.org/reports/report045.asp

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