Recently, the hepatitis B vaccine birth dose has come under scrutiny. For that reason, we thought it would be of value to look at the origins and reasoning behind the birth dose. (Armstrong GL, et al. Childhood hepatitis B virus infections in the United States before and after hepatitis B immunization. Pediatrics. 2001 Nov;108(5):1123-8).
The hepatitis B vaccine was first recommended in 1982 for all infants born to mothers infected with hepatitis B virus (HBV). The recommendation was expanded in 1988 to include all infants in certain racial and ethnic groups with high rates of chronic hepatitis B infections. However, by 1991 it had become clear that many children remained at high risk for hepatitis B infections because of incomplete maternal screening and, more importantly, because a substantial proportion of hepatitis B infections occurred in children born to mothers with negative hepatitis B surface antigen. For that reason, in 1991 the CDC recommended that all infants receive hepatitis B vaccine. Because infants less than 12 months of age infected with hepatitis B virus have a 90% chance of developing cirrhosis or liver cancer, it is critical to have an infant immunization program.
Using published and unpublished surveys, CDC researchers found that prior to the universal infant recommendation for hepatitis B vaccine, about 32,000 children less than 10 years of age were infected with HBV, only half of whom acquired the virus from mothers infected with HBV. About 65% of chronic infections were among children born to mothers who did not have serological evidence of infection.
Transmission of hepatitis B to infants born to seronegative mothers can be explained in part because the virus can survive up to seven days on surfaces and can be detected in saliva as well as in shared washcloths, toothbrushes, towels or other household items.
Since the 1991 universal infant recommendation, hepatitis B infections in children has been virtually eliminated.
Recently, the hepatitis B vaccine birth dose has come under scrutiny. For that reason, we thought it would be of value to look at the origins and reasoning behind the birth dose. (Armstrong GL, et al. Childhood hepatitis B virus infections in the United States before and after hepatitis B immunization. Pediatrics. 2001 Nov;108(5):1123-8).
The hepatitis B vaccine was first recommended in 1982 for all infants born to mothers infected with hepatitis B virus (HBV). The recommendation was expanded in 1988 to include all infants in certain racial and ethnic groups with high rates of chronic hepatitis B infections. However, by 1991 it had become clear that many children remained at high risk for hepatitis B infections because of incomplete maternal screening and, more importantly, because a substantial proportion of hepatitis B infections occurred in children born to mothers with negative hepatitis B surface antigen. For that reason, in 1991 the CDC recommended that all infants receive hepatitis B vaccine. Because infants less than 12 months of age infected with hepatitis B virus have a 90% chance of developing cirrhosis or liver cancer, it is critical to have an infant immunization program.
Using published and unpublished surveys, CDC researchers found that prior to the universal infant recommendation for hepatitis B vaccine, about 32,000 children less than 10 years of age were infected with HBV, only half of whom acquired the virus from mothers infected with HBV. About 65% of chronic infections were among children born to mothers who did not have serological evidence of infection.
Transmission of hepatitis B to infants born to seronegative mothers can be explained in part because the virus can survive up to seven days on surfaces and can be detected in saliva as well as in shared washcloths, toothbrushes, towels or other household items.
Since the 1991 universal infant recommendation, hepatitis B infections in children has been virtually eliminated.