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Hepatitis B Immunisation in Babies – Why Do It?

13 Oct 2005 7:41 PM - Dr Roger Morris

Hepatitis B is a serious disease that is caused by a blood-borne virus that infects the liver. The Hepatitis B virus is found in infected body fluids such as blood, saliva and semen. The virus can be transmitted by blood to blood contact (including contact with cuts or abrasions, contaminated needles/syringes, contaminated body piercings, needlestick injuries and sexual contact). Babies whose mothers have Hepatitis B are at very high risk of being infected with the virus at birth. Most young children, and about five per cent of adults, who catch the virus become carriers. Babies who contract Hep B may only have mild symptoms, or have no symptoms at all. However, many of these babies will go on to carry the virus in their bloodstream for many years and may then be able to pass it on to other people. As many as 25% of Hep B carriers may develop liver cancer or liver failure later in life.

The initial strategy to control hepatitis B in Australia started in 1988. It targeted children who were at particular risk for hepatitis B disease at birth, for example those with mothers who were hepatitis B carriers. In 1996 the National Health and Medical Research Council (NHMRC) recommended a universal hepatitis B vaccination program for all infants and adolescents. This was because the targeted program did not fully protect the high-risk children. The rationale for the universal immunisation of all babies just after birth is not only to prevent vertical transmission (from mother to child), but also to prevent horizontal transmission in the first months of life from a carrier living amongst household contacts. It is important to start the Hep B immunisation as soon as possible after birth to achieve this goal. This is part of a long-term prevention strategy to reduce the amount of Hep B disease in our community, to reduce the illness and death from complications due to the disease and to eventually eliminate Hepatitis B from Australia.

The Australian Immunisation Schedule recommends that all newborn babies receive their first Hep B immunisation before mother and baby leave hospital. Further doses are then recommended at 2, 4 and 6 months and are combined with other routine vaccinations. Babies who have been fully immunised against Hep B will usually not require any boosters and are likely to maintain long term immunity to the disease into adulthood. The Hepatitis B injection is well tolerated and serious side effects are exceedingly rare. If side effects occur, they are usually mild and may include low grade fever, irritability or local discomfort at the site of injection (at most 2-3% of children immunised).

Ultimately, the choice to immunise newborns against Hep B is a decision for parents to make, but it is strongly recommended that parents consent to early Hep B immunisation as recommended by independent expert medical bodies such as the NHMRC.