hep b jab

[morocco]

OK I know it's the Easter weekend and you're all off getting stuck in traffic but if anyone's around ....
Does anyone know anything about the hep b vaccine for babies? My ds is due to have his at 6 months as it is routine here but I know that is not the case everywhere - has anyone on mumsnet given it to their child? or heard terrible things about it?

Hi morrocco ... my DS had his hep b jab when we moved to NZ ... a requirement for all children applying for residency here ... not a requirement for adults though which is a bit strange ...
Anyway ... no side effects AT ALL ... just the usual howls when the needle went in and they stopped as soon as he was given a treat! He had 3 jabs in total each a month apart ...
HTH ...

He was 2 and a half BTW ... but I know that it is the norm for all NZ kids to 'be done' as babies ...

Hep B is given routinely in Australia too. I didn't have DD done but a friend whose children were younger and who gave birth to another whilst we were there had all there of hers done (or planned to). They ended up moving back to the UK shortly after the baby was born so perhaps she didn't vaccinate in the end.

I spent quite some time googling it but I can't remember what I found - sorry! - other than I didn't feel DD was particularly at risk.

well any vaccination carries a risk of side effects- and they can be serious side effects - although the risk of that may be small.

So your best bet is too decide whether or not your child is at risk of hep B. In the UK there are usually less than 50 cases contracted abroad. Used to be confined to IV drug users and gay men. Now it is found in donated blood. Some parts of the world 2 to 7% of the population may be carriers. Of the reorted cases 1.4% are fatal.

Not all that popular with drs. In a survey in N carolina only 3rd of peads and a fifth of family drs supported the jab.

Srudy in NZ showed a lot of side effects - some life threatening. The lancet (1993) reports on the case f 21 year old who developed glomerulonephritis (a kidney disease) following 3rd hep B shot. As usual duration of protection not known.

And so it goes on... Sorry don't know much about hepB vaccine- just dredged that up from my usual source (the vaccination bible) so a bit bitty.

If I was you I would just find out the risks of contracting the actual disease then take it from there.

sorry haven't got time to set up a link but the following may be helpful. It had hep-b info www.vaccine-info.com/

thanks everyone - still mulling it over but jimjams website certainly made me think twice. Most importantly I just can't see that ds is a high risk category unless he needed transfusion - am I being daft here for thinking it would prob not work anyway in that case?
It also reminded me of a friend who had one - they messed it up so badly she had an open sore on her arm (and I mean the size of 10p piece and deep and completely unhealable) for at least a year - cant believe I forgot!
oh well - will keep thinking about it

something else occurs to me. Do they not screen donated blood for hep-b or is that not possible?

Personally- and I speak from the somewhat biased experience of someone who hasn't had an entirely happy experience with vacinaiton (for ds1- ds2 hasn't had any- so I do tend to err on the side of caution) but if you think that the only way your ds could get hep-b is by tranfusion then I wouldn't give the vaccination.

TBH I wouldn't give any vacination if they were only likely to get the disease by transfusion.

I once got into a discussion with a public health official about vaccination. (I think he was in charge of vaccination in one NHS trust). Anyway we were talking about benefits/risks etc, and it struck me that he was far more concerned about my children not receiving measles vaccination than meningitis C. Now in my mind I still feel that not giving the meningitis C (to ds2- ds1 has had it- won;t get any boosters though) was a far harder decision for me to make than the measles. If they got measles they would probably be OK, if they got meningitis C they quite possibly wouldn't be. It made me realise though about the way in which the risks should be approached. So however nasty the disease, if they're not very likely to get it (and I assume hep B comes into this category) then you need to be pretty sure that the potential side effects are acceptable, or the risk of getting the side effect is minimal.

Does that make sense?

yes jimjams - kind of what I was thinking too. TBH I never really thought about it much for the first set of jabs - in fact, I was really relieved to get them done - had become a touch paranoid about letting ds meet anyone in case they had tb (unlikely even here so I think my paranoia was a touch out of control)but hep b doesn't seem as urgent as all the others or even nec right now - unless things change it seems a decision he can make himself as an adult.

Are you sure it's hep b and not hep a that they are giving. Hep a is standard in parts of the usa that have large immigrant populations. It is waterborn and probably relatively common in morocco. I am very pro-vaccine, but don't really see any reason to give hep b to a small baby. (more important for a sexually active teenager)

hep- a vaccination is only given to children over 2. It usually resolves by itself anyway.

yes it does usually resolve itself, but having had hepatitis greatly increases your chances of liver cancer later in life. The "trauma" to the liver from the hepatitis causes cell damage which mutates them into cancerous cells....

oh not trying to get into a pro/con hep-a fight. Just saying it probably wasn't hep a as morocco's ds is only 6 months and hep a is only given when kiddies are over 2.

yes definitely hep b but I'm really interested to hear that about hep a as no doctor I asked had been able to answer that question - I had it before coming here and wondered why they didn't give it to kiddiwinks as well.

morocco may be that young kiddies aren't deemed at high risk (although as one risk factor is attending day care that seems unlikely). It may be that for some reason the vaccination doesn't promote a very good immune repsonse in the very young (this is true of measles if given below say 15 monthsish). Or it may be that the risk of side effects is too high in the under 2s. You could always contact the manufacturers and ask. They're usually pretty good at replying to enquiries.

I think it doesn't promote a good immune repsonse in the under 2's.

Hi Morocco,
Getting Hep B as a child is much more dangerous than getting it as an adult. A child is much less likely to "clear" the virus, and so more likely to go on to become a chronic carrier (more likely than not if infected as an infant).

Being a long-term carrier is bad news - it brings a very much elevated risk of cirrhosis and liver cancer. The disease is very common in some parts of the world. Incidence in some countries is as high as 20% of the population.

By the by, hep b is fairly infectious and can spread through saliva and cuts etc as well as through sex and sharing needles. It can also survive outside the body for long periods in dried blood etc. For these reasons, anyone living with someone with Hep B is advised to be vaccinated. This infectiousness is probably also the source of the day-care risk factor. All healthcare workers and care assistants etc are routinely vaccinnated in the UK. And yes, donated blood is screened for Hep B.

Hope this helps,
tech

oh no tech - I'd just decided to wait a while before making final decision but now am all worried again!!
thanks for info - it was something I hadn't heard of or even thought of before.

As usual the vaccination decisions are a nightmare.

Morocco- one method I've found useful in deciding whether or not to give a jab is to take the following decision process. Initially I ignore all informaiton about the possible side effects as these are a) always being added to b) always argued about c) any vaccination had a risk of a serious side effect and the risk although small is still present and anyone could be the one in a million iyswim.

SO having ignored all that I just find out what the risk of my child contracting that particular disease at this stage in his/her life is. So for example I haven't given my 15 month old tetanus yet, but I may do next year- at the moment I don't feel he's a high risk of getting a dirty puncture wound- certainly not without my knowledge- so I'm still on that stage of the decision making process.

If I was you I would find out how likely your child is to get hep-b. Most of the stuff I've browsed lists sexual transmission, or transmission of contaminated blood products. However these have been generally UK/US sites and the situation may be different in morocco. There will be figures somewhere for different transmission routes. Once you have those figures then you can decide whether your ds is at risk.

If you decide that your ds is at risk then you can move onto the next stage of the process. How well does the vaccination work? What are the listed side effects? How serious is the disease if he gets it? etc etc.

I've found that method of decision making to bring some sanity back. I do occasionally wake in a blind panic at night- lol But I do know why I have made the decisions I have and I can go thorugh them again- and see if my answer is still the same.

HTH

This probably doesn't help with your query but my ds had a hep b jab as we were in Australia for his first vaccination. They don't give Men C there so he missed out on that. We returned for his 4 month jabs and he got his Men C then. At 6 months I asked for him to be given a Hep B jab to keep the first one going as in Australia they give it at 2 months, 6 months and 12 months and then the dose is finished. I asked for it as we knew we would be back in Oz for his 12 month jab and as he would be getting it then I thought it sensible to continue it.

It didn't give him any side effects what so ever and as we will one day return to Oz I figured it appropriate for him to continue. They obviously don't have such an issue with Men C in Australia but I didn't think it hurt him to have that as we would be living here for a few more years and to be fair who knows where we will live next. If you travel due to work etc and have to reside in other countries it may be worth considering giving it to your child.

Morocco, hep b vaccine is routine here in Belgium at 4-6 months. We queried this with our paediatrician, as with four or five other vaccines already we felt dd might be heading for overload. Dr said that he didn't see the point of giving hep b so early as it's only transmitted by blood or sexual fluid. So he recommended us waiting until dd started full-time nursery where she'd be in contact with more people; in the end she had it when she was 2 1/2, with no side effects at all not even a temperature, unlike with other vaccinations.

I'm not going to get into a vaccination debate either, but for the benefit of people who read Jimjams last post and are thinking about vaccination pros and cons-

the tetanus organism is widespread and survives quite happily in soil, so the greatest risk of getting it is if you have a contaminated wound. It doesn't particularly have to be a puncture wound, but puncture wounds are harder to thoroughly clean, so the bug is more likely to multiply and cause problems. If a person, child or adult, is not vaccinated against tetanus and has a dirty wound, they will be given a gamma globulin jab at Casualty which gives them immediate immunity, and they will be advised to attend their gp for the appropriate vaccinations. Tetanus is a special case, as you know you have a wound, and the gammaglobulin is widely available. With other diseases such as measles or meningitis, you don't know you've contracted the disease until its too late. Gammaglobulins would not generally have any effect at this stage.