I've seen many posts on here poo-pooing the idea of Hep B for babies. "My child isn't around IV drug users" "My toddler isn't going to be having UNPROTECTED SEX anytime soon :snort:"
Well, here is why your infant/toddler should get hepatitis B:
http://www.cdc.gov/hepatitis/index.htmHepatitis B is a liver disease caused by the hepatitis B virus (HBV). It ranges in severity from a mild illness, lasting a few weeks (acute), to a serious long-term (chronic) illness that can lead to liver disease or liver cancer.
Transmission: Contact with infectious blood, semen, and other body fluids from having sex with an infected person, sharing contaminated needles to inject drugs, or
from an infected mother to her newborn.
Vaccination: Hepatitis B vaccination is recommended for all infants, older children and adolescents who were not vaccinated previously, and adults at risk for HBV infection
http://www.cdc.gov/hepatitis/HBV/HBVfaq.htm#treatmentHBV is transmitted through activities that involve
percutaneous (i.e., puncture through the skin) or mucosal contact with infectious blood or body fluids (e.g., semen, saliva), including
* Sex with an infected partner
* Injection drug use that involves sharing needles, syringes, or drug-preparation equipment
*
Birth to an infected mother
* Contact with blood or open sores of an infected person
* Needle sticks or sharp instrument exposures
* Sharing items such as razors or toothbrushes with an infected person---My own commentary---
Just from the post above, Hep B is transmitted if the skin is broken (percutaneous) or mucosal, and comes in contact with infectious body fluids (saliva being one)
Knowing many toddlers in my life, there is one thing that toddlers do...they BITE. Biting causes the skin to be broken (percutaneous infection) and introduces infectious body fluids (saliva) into that open wound. Alternately, the one biting can have infectious body fluids (blood) introduced into their oral mucosa (mouth)
....
From the 2nd link above:
How serious is chronic HBV infection?Approximately 25% of those who become chronically infected during childhood and 15% of those who become chronically infected after childhood die prematurely from cirrhosis or liver cancer, and the majority remain asymptomatic until onset of cirrhosis or end-stage liver disease. In the United States, chronic HBV infection results in an estimated 2,000–4,000 deaths per year
http://www.cdc.gov/hepatitis/HBV/PerinatalXmtn.htmHepatitis B virus (HBV) infection in a pregnant woman poses a serious risk to her infant at birth. Without postexposure immunoprophylaxis,
approximately 40% of infants born to HBV-infected mothers in the United States will develop chronic HBV infection, approximately one-fourth of whom will eventually die from chronic liver disease.http://www.cdc.gov/hepatitis/Statistics.htmIncidence of hepatitis B, United States
Year
Reported Acute Cases Estimated Acute Cases Estimated Total New Infections
1980 19,014
53,000
208,000
1981 21,151
59,000 229,000
1982 22,176
62,000 239,000
1983 24,319
68,000 267,000
1984 26,116
73,000 281,000
1985 26,612
74,000 287,000
1986 26,106
73,000 283,000
1987 25,915
72,000 287,000
1988 23,175
65,000 253,000
1989 23,421
65,000 255,000
1990 21,277
59,000 232,000
1991 17,911
50,000 193,000
1992 16,126 45,000 175,000
1993 13,361 37,000 144,000
1994 12,517 35,000 133,000
1995 10,805 30,000 113,000
1996 10,637 30,000 112,000
1997 10,416 29,000 110,000
1998 10,258 29,000 109,000
1999 7,694 21,000 79,000
2000 8,036 22,000 81,000
2001 7,844 22,000 78,000
2002 8,064 23,000 79,000
2003 7,526 21,000 73,000
2004 6,212 17,000 60,000
2005 5,494 15,000 51,000
2006 4,758 13,000 46,000
http://www.cdc.gov/hepatitis/SurveillanceGuidelines.htmAcute and chronic HBV infections are a major cause of morbidity and mortality in the United States.
Acute hepatitis B is one of the most commonly reported vaccine preventable diseases; in 2000, 8036 cases were reported (Annual summary of notifiable diseases, 2001).
However, because most newly infected persons are asymptomatic 3, and because even symptomatic persons are underreported 4, reported hepatitis B cases markedly underestimate the incidence of HBV infection Based on catalytic modeling of data from the second and third National Health and Nutrition Examination Surveys, the estimated number of new infections in 2000 was 81,000, a decrease of 70% from a peak of approximately 280,000 in the mid-1980's. In addition to acute disease,
approximately 1.25 million persons in the United States have chronic HBV infection. These persons are at increased risk for chronic liver disease, including cirrhosis and hepatocellular carcinoma,
and they are the major reservoir of ongoing HBV transmission.Less than 5% of the HBV infections that occur among children are reported as cases of acute hepatitis B to CDC because HBV infections that occur in infants and children rarely produce signs or symptoms of disease.Furthermore, chronic HBV infection develops in approximately 90% of children infected at birth and 30%-60% of children infected between 1 to 5 years of age compared with 2%-6% of older children and adults; thus, prior to routine immunoprophylaxis of infants and children, cases occurring in children accounted for a disproportionate amount of the disease burden due to chronic infection.In addition to infections occurring in childhood, CDC estimates that 20,000 (95% confidence interval, 15,000 to 32,000) infants are born to HBsAg positive mothers each year 5. Post-exposure prophylaxis is highly effective in preventing transmission of HBV from mother to infant.
However, an estimated 1000 of these infants become chronically infected with HBV each year because not all infected mothers are identified and not all infants receive appropriate post-exposure prophylaxis. Although perinatal HBV infections have been nationally notifiable since 1995, reported cases have not been reliable for monitoring the number of perinatal infections that are occurring in the United States because of a lack of follow-up serologic testing of infants born to infected mothers.
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So....in a nutshell for those who have problems with big words:
1) Children bite other children and can spread Hepatitis B that way
2) Infected mothers can transmit HBV to their infants during childbirth
--a) Not all mothers who are HBV positive are identified prior to giving birth
3) The number of reported cases and suspected cases are very different because not everyone is tested for Hepatitis B, especially since the virus can remain dormant, therefore, causing a person to be asymptomatic, never raising the alarm to be tested
THEREFORE, you don't KNOW that you don't have Hepatitis B unless you've been tested.
THEREFORE, you don't KNOW that anyone your child comes in contact with doesn't have Hepatitis B unless THEY've been tested, and told you the results
THEREFORE, you don't KNOW that your child will never come into contact with another person's blood, semen, or saliva.
Give this a chew:
http://www.aacap.org/cs/root/facts_for_families/child_sexual_abuseChild sexual abuse has been reported up to 80,000 times a year, but the number of unreported instances is far greater...
http://www.advocatesforyouth.org/PUBLICATIONS/factsheet/fsabuse1.htm#24A recent Department of Justice report found that half of the women who reported rapes in 1992 were under the age of 18, 16 percent were under 12
Children are most vulnerable between ages eight-12. The average age for first abuse is 9.9 years for boys and 9.6 years for girls.6 Victimization occurs before age eight in over 20 percent of the cases. Another study found 24 percent of female child sexual abuse survivors were first abused at age five or younger.
The National Resource Council estimates the percent of the U.S. population which has been sexually abused to range from a low of 20-24 percent to a high of 54-62 percent of the population; the higher estimate includes sexualized exposure without touching, such as masturbating in front of the child.
The largest retrospective study on the prevalence of child sexual abuse found 27 percent of women and 16 percent of men reported abuse.Studies examining victimization of boys have recorded rates ranging from 3 to 31 percent of all men.
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So the chances of your child biting, or being bitten by a child are, I would suppose, pretty good. I cannot find exact statistics of children who bite children, but out of 25 children I have known, plus myself (that makes 26), 100% of them have bitten, or were bitten by another child at some time in their life.
Then there's also the very high chance that your child could be the victim of child sexual abuse and come into contact with blood and body fluids that way.
Hep B is also spread via fecal matter as well, especially fecal matter that makes its way into a cut, or comes into contact with mucosa. I think that the number of children in daycare or nursery school that wear diapers is pretty high. The number of children who scratch their butt then don't wash their hands is pretty high as well....2 year olds aren't known for their hygeine standards.
So actually, your child has a pretty fucking good chance at being EXPOSED to hepatitis B. Isn't that enough reason to vaccinate? Or are you 100% certain that every person you know, every person your child will ever come into contact with EVER until they're 18 years old, is hepatitis B negative? You're willing to risk your child's liver and possibly their life on that? Seriously?