Jul 292011

*** I had writen this entry over a year ago, and am re-posting it since yesterday was World Hepatitis Day.

Hepatitis B virions with Dane particles

Image by Microbe World via Flickr

A common question about vaccines has to do with Hep B and goes like this: Heb B is a sexually transmitted disease. Why am I vaccinating my newborn for it? This is not a question without merit, and a very good question to ask. Parents should always be encouraged to seek more information. So, in this entry I will try my best to scour the web for information and come up with a good answer.

It is true that Hep B can be transmitted sexually, however it is not transmitted ONLY sexually. The virus passes from one individual to the other through various bodily fluids, including blood, semen, vaginal fluids, saliva, and other body fluids. Here are some ways in which the disease can spread:

  • Blood transfusions
  • Contact with blood in health care settings
  • Had direct contact with the blood of an infected person by touching an open wound or being stuck with a needle
  • Had unprotected sex with an infected person
  • Received a tattoo or acupuncture with contaminated instruments
  • Shared needles during drug use
  • Shared personal items (such as toothbrushes, razors, and nail clippers) with an infected person

Furthermore, a baby can get the virus from the mother during childbirth, if the mother is infected.

Hepatitis B virus can survive outside the body at least 7 days. During that time, the virus can still cause infection if it enters the body of a person who is not infected.

Effects of Hepatitis B infection

Hep B, is not curable! It comes in two flavors; acute and chronic. Most newborns and about 50% of children that become infected develop the chronic version.

Chronic Hepatitis B increases the risk for liver damage including cancer. Hep B is fatal in about 1% of cases. So on average, if we did not vaccinate, 1 out of 100 children that were infected would die, of this disease alone!

The younger a person is when infected with Hepatitis B virus, the greater his or her chance of developing chronic Hepatitis B. Approximately 90% of infected infants will develop chronic infection. The risk goes down as a child gets older. Approximately 25%–50% of children infected between the ages of 1 and 5 years will develop chronic hepatitis. The risk drops to 6%–10% when a person is infected over 5 years of age.

About 15%–25% of people with chronic Hepatitis B develop serious liver conditions, such as cirrhosis (scarring of the liver) or liver cancer.

Why vaccinate?

I believe, after this short discussion it becomes clear why newborns are vaccinated against this disease at birth. Let me recap:

  1. Hep B is not only transmitted sexually, but through various bodily fluids including blood, and sharing of personal items (something babies are bound to do)
  2. The newborn can catch the infection from the mother during childbirth.
  3. Almost all newborns and 50% of children that contract the disease will develop the chronic version of it.
  4. The chronic Hep B, increases chances of liver disease, including cancer.
  5. Hep B has a fatality rate of 1%

All these reasons support the decision to vaccinate at birth. Also, it appears the Hep B vaccine may help prevent infection if it is given within 24 hours of exposure , making it even more important to give as soon as a baby is born.

According to the CDC, Hep B infection rates have gone down by about 82% since 1990 when routine Hepatitis B vaccination of children was implemented and has dramatically decreased the rates of the disease in the United States, particularly among children.


Hep B is a serious disease. If one gets the chronic version, there is no cure for it. It damages the liver; about 15%–25% of people with chronic Hepatitis B develop serious liver conditions, such as cirrhosis (scarring of the liver) or liver cancer. Even if it does not it will complicate life for the infected person. For example, someone with chronic hepatitis should avoid alcohol and should always check with their doctor or nurse before taking any over-the-counter medications or herbal supplements. This even includes medications such as acetaminophen, aspirin, or ibuprofen.

Babies can contract Hep B various ways, through contact with various bodily fluids from infected people. A baby can also contract the virus during birth, from the mother, who may be a carrier and not know about it, since carriers can be asymptomatic for a long time (20%-90% chance depending on the type of virus the mother has). Many people who have chronic hepatitis B have few or no symptoms. They may not even look sick. As a result, they may not know they are infected. However, they can still spread the virus to other people.

The Hep B vaccine can protect against the infection if given within 24 hours of the exposure to the virus. Thus the need to vaccinate immediately after birth. The chances to contract the disease, through its various infection methods, are not remote; once contracted the chance of an infected newborn to develop the chronic version are extremely high; and once the chronic version is present it cannot be cured, could lead to liver failure and cancer, and other complications. 1 in 100 people who catch Hep B will die of the disease. A few vaccine shots can prevent that from happening.


  1. Google Health
  2. Centers for Disease Control and Prevention
  3. Medline Plus
  4. Wikipedia
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  9 Responses to “Hepatitis B – Why vaccinate if it is a sexually transmitted disease?”

  1. [...] I’ve got a new entry up at the Vaccine Central. This one deals with the question of Hep B, why do we vaccinate newborns if it is a sexually transmitted disease? Well, besides the fact that the baby is coming out of the mother’s vagina, turns out there [...]

  2. Could it also be argued that vaccine rates tend to drop off as people get older, and this is a good way to not only ensure immunity, but ensure that they actually get the vaccine. Just look at statistics for how many adults actually get the pertussis booster…

  3. In places where Hep B is common in the adult population, it makes sense to vaccinate infants. However, there are other equally valid ways to administer this vaccine effectively. In Ontario, pregnant women are screened for Hep B during routine doctor’s visits, and since everyone has health insurance through the provincial plan, it’s very rare for a woman not to have good prenatal care. I believe the vaccine is offered to children of mothers who screen as positive. For everyone else, the risk of infection during childhood is fairly small, so the vaccine is offered through the public health department during seventh grade, that is, at the age of twelve or thirteen. Parents have to sign a permission form and the vaccine is administered at school. Uptake is nearly universal, upwards of 98%.

    There are two big advantages to this system. One is that immunity is at its highest as young people enter the period of highest risk: their teens and twenties. Another is that it doesn’t rely on parents taking their children to the doctor, so uptake is very good.

  4. It makes sense to vaccinate infants if the disease still exists (and of course the vaccine works and is reasonably safe), then give a booster shot around 12 done at the school (and the only exemptions should be for valid medical reasons).

    Brings up the question of whether Hep B is a disease we could potentially eliminate like we’ve done to smallpox and rinderpest?

  5. Here is some information which shows that giving newborns the hepatitis B jab is not only insane, but also dangerous:

    Ian’s Voice Home Page
    iansvoice.org/ – CachedThis site is dedicated to giving voice to our son Ian Larsen Gromowski. Our child died of an adverse reaction to the hepatitis B vaccine.

    A Vaccine Horror Story

    Go here and scroll down to your state to find out how to get a birth exemption:

  6. [...] Why Vaccinate if it is a sexually transmitted disease? (Vaccine Times) [...]

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