Hepatitis B shot for Newborn Boy?

amother

Apricot

Fri, Feb 24 2017, 4:12 am

I wasn't planning to give the HepB shot at the hospital right after birth, because although I'm pro-vaccine in general, I don't think it's necessary to give the shot to a few-hours-old baby who will be iy'H coming home to a safe and clean environment.

However, I'm having a boy this time and I'm wondering if it's better to give it. Is there any increased danger of HepB from a bris?

Iymnok

Fri, Feb 24 2017, 4:14 am

Does the mohel have hepB?

amother

Apricot

Fri, Feb 24 2017, 6:30 am

Iymnok wrote:

Does the mohel have hepB?

LOL, I hope not!
Anything else I have to worry about? Like the equipment sterilization, or something like that? I never made a bris before...

Ruchel

Fri, Feb 24 2017, 7:48 am

For a newborn? I'm not even sure you'll find a doctor who will agree!

amother

Mauve

Fri, Feb 24 2017, 8:33 am

Ruchel wrote:

For a newborn? I'm not even sure you'll find a doctor who will agree!

Ruchel,

In the US, Hep B vaccine is routinely given to a newborn before they leave the hospital.

That being said, I highly doubt your son will be at any increased risk and I would not give it. The pediatrians I work with don't recommend it at birth due to the extremely low possibility of Hep B exposure in the frum population.

miami85

Fri, Feb 24 2017, 8:36 am

I usually get it done at the first doctor's visit which is usually b4 the bris--to make sure the baby is healthy for the bris.

Besides HEP B is only contagious through bodily fluids, so highly unlikely, unless your mohel does MPB--but even then he would have to have it and that's unlikely.

amother

Navy

Fri, Feb 24 2017, 8:38 am

amother wrote:

LOL, I hope not!
Anything else I have to worry about? Like the equipment sterilization, or something like that? I never made a bris before...

Find out. Make sure the mohel has been tested and regularly gets tested.
Mazal Tov!

amother

Gold

Fri, Feb 24 2017, 1:45 pm

One shot won't give immunity. One gets hep b from s ex and iv drug use which makes infants very unlikely to catch it u less they breast feed from a mother who has it. I don't know if it's transmissible from saliva but I definitely wouldn't want a Mohel with hep be doing metzitza b'pe on my son. Because of the way it's transmitted it is hopefully less common in frum world so u likely you have to worry about it. Besides, the Mohel was likely vaccinated and immune.

cnc

Fri, Feb 24 2017, 1:49 pm

My pediatrician recommends I push it off as long as possible (even for my boys).

ectomorph

Fri, Feb 24 2017, 2:37 pm

I let them give it. I figure my kids play in a park with kids from third world countries.

amother

Violet

Fri, Feb 24 2017, 3:34 pm

You can gice at six months too.

amother

Lemon

Sun, Feb 26 2017, 2:55 pm

I'm a biologist, I worked for years doing academic research (not for any big pharma or anything) on liver disease, in particular on long term effect of viral hepatitis infections.

The hep b vaccine is very safe. I would want at least 2 doses of the vaccine before sending the kid to daycare or a daily babysitter. If you are in the US, and going back to work at 6 weeks, then best to give it now at birth and then again around 1-2 month (before the kid goes daycare), so it has time to start to work before your kid is exposed to other kids and adults. People can pass the infection even when not symptomatic

Before a bris, I would want to have the baby vaccinated for hep b beforehand. In general, everything is supposed to be sterile at a bris, but I consider getting vaccinated beforehand to be a relevant precaution.

If you live in a country where hep b rates are high, or have someone in your household with hep b (or another relative who will be indirect contact with the baby), or have people in your household who haven't been vaccinated for hep b (since even asymptomatic people can pass it along), absolutely do it at birth.

Chronic infection / liver disease / liver cancer down the line from hep b infection is much more common the younger you are (in particular, if you get it before age 5), so it's best to vaccinated as early as possible, which is why it's recommended at birth.

amother

Gold

Sun, Feb 26 2017, 3:08 pm

amother wrote:

, so it's best to vaccinated as early as possible, which is why it's recommended at birth.

No that's not why it's recommended at birth. Vaccines are recommended in first year because that's when moms are more likely to take them to the doctor and according to her b insert the reason it's recommended is because they failed to reduce incidence of hep b by only targeting high risk population NEWSFLASH--high risk population doesn't tend to take very good care of their health. That doesn't make most babies at risk and as a biologist I'm sure you're aware that hep b isn't contagious through casual contact.

amother

Lemon

Sun, Feb 26 2017, 3:45 pm

amother wrote:

First, I just want to say that I'm not here to argue with anyone on whether vaccines are right or wrong. Or if vaccines at birth are right or wrong. Or if anything is right or wrong The OP asked what people would do, so I explained what I would do and why.

To answer your comments though:

Correct, casual contact does not transmit hepatitis. It can be transmitted by saliva though (e.g., documented cases from sharing a toothbrush, being bitten by another kid with hepatitis, an adult chewing up food for a baby), but this route is really not very effective for virus transmission. Again, these are really not common at all, and are also generally irrelevant for a newborn baby. Like I said, best before daycare. But most vaccines are not given at birth, they are only given later, even if at a month. So why is this one recommended at birth? There are several reasons. The vaccine is really most effective after 3 doses. And most babies get all 3 doses by 6 months (or older), which is the time when the above factors become relevant. If you only get your first does at 6 months, you are not fully protected yet. And yes, as you said the more likely you are to do the first dose at birth, the more likely you are to do all 3 doses within the first year, to make sure you are fully protected for life. Also, like I mentioned in my first post on this, the age group at highest risk for significant long terms effects is kids under 5 - this is somewhat unique to hep b, as many other diseases are dangerous when you get them, but don't have longer term effects later. So the earlier you are fully immune, the less chance of long term health problems. Additionally, babies also spread hep b to others, since most babies have no symptoms of the initial infection (the chronic infection causes the problem, even if the original infection has no symptoms), so that's another reason why it's good to vaccinate early. If your kid had diptheria, you would keep them at home away from people, but you might not even know if your kid had hep b, and your baby could spread it around. But this isn't so relevant I presume. But it's another reason why it's good to have babies fully immunized as early as possible. Lastly, hep b at birth is an important last resort for women who may have hep b and not know it, because it is transmitted at birth from mother to baby. Again, I presume not relevant here, but there is a logic as to why it's given at birth.

Importantly, I never said that most babies are at risk. Because vaccines have been in place for ~25 years, thankfully most babies are not at risk. But most babies who do get hepatitis are at much higher risk of developing chronic infection and subsequent liver disease and even liver cancer, than older children or adults. Which is why it's important to get in those 3 doses earlier rather than later.

In my opinion, the benefits of doing hep b at the hospital far outweigh the risks .