Parents often wonder why we recommend giving the hepatitis B vaccine to brand-new babies before they even go home from the hospital. They may think, “Isn’t hepatitis B a sexually transmitted infection? Why would my baby need that?” Great question!
Hepatitis B [archived link] is a dangerous virus that can cause long-term health consequences such as liver failure, cirrhosis, and even liver cancer. It can cause both acute and chronic infections. Acute infections happen within 6 months of exposure to the virus. Acute infections can turn into chronic infections, causing lifelong medical problems and liver disease. People with hepatitis B might feel tired, have yellow changes to their skin or eyes, joint pain, nausea, vomiting, or abdominal pain. Many folks have no symptoms, even as irreversible damage is being done to their liver by the virus. Between 600,000 to 1.25 million people are chronically infected with hepatitis B, and up to 4,000 people each year die in the US. The risk of an acute infection becoming chronic is highest in kids [archived link]. About 90% of infected infants and 30% of infected children ages 1-5 will develop a chronic infection. Less than 5% of infected adults will go on to get a chronic infection. Preventing our kids from getting hepatitis B infections in childhood is super important to protect their health.
It is true that hepatitis B is often sexually transmitted, but there are other ways to get the virus that can infect kids and put their health at risk. In folks with a hepatitis B infection, the virus can be found in blood, semen, vaginal secretions, and saliva. It is most often spread by percutaneous exposure (like needle sticks or injection drug use) and sexual contact. But think about all the times kids are exposed to other kids’ bodily fluids. Picture all the scrapes, cuts, nose bleeds, and bites that happen when kids are playing or fighting together. That’s a lot of opportunities to get exposed and get infected. Hepatitis B is also a pretty hardy virus, and can survive on surfaces for up to 7 days and can be transmitted even when blood isn’t visible.
Even though only about 1% [archived link] of acute hepatitis B infections in the US happen in children under the age of 5, nearly 30% of chronic infections were obtained during childhood. 1 out of every 2 people infected with hepatitis B don’t even know they have it and at least 28% of all folks with hepatitis B had no serious risk factors for the disease. This means that people can spread the disease to other people unknowingly. This is why vaccination before our kids even have the chance of exposure is so critical.
Hepatitis B can also be transmitted during birth if the pregnant person doesn’t know they have an infection. It is recommended that all pregnant people are tested before delivery. Unfortunately, that doesn’t always happen and even when it does, sometimes a new infection is acquired after that test is performed. We do not have a 100% perfect, guaranteed way to ensure that the birthing person doesn’t have hepatitis B. Giving the first dose of hepatitis B vaccine within 24 hours of life reduces the risk of a baby catching hepatitis B from birth.
Critically, the hepatitis B vaccine is safe and effective at reducing hepatitis B infections. This vaccine has a proven track record of safety and has been around since 1982. The vaccine is about 95-98% effective in protecting from chronic hepatitis B infections and lasts for at least 20 years. Serious side effects from hepatitis B vaccination are exceedingly rare and the risk of a serious allergy [archived link] to the vaccine is about 1 per million doses administered. That’s about the same risk as getting struck by lightning!
Immunizing our babies is one of the best strategies to protect kids from hepatitis B infections and developing serious health problems later in life. If you have questions about the hepatitis B vaccine for your or your loved ones, please reach out to your primary care clinician.
