Re: Hep B immunization article - Here it is

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Wednesday February 21 12:35 PM EST

Shots Snafu Puts Newborns at Risk

By Jeff Kelliher

HealthScout Reporter

TUESDAY, Feb. 20 (HealthScout) -- A temporary change in vaccine

recommendations for infants has lasted longer than

intended and could be endangering newborns, the government says.

In July of 1999, the American Academy of Pediatrics and the U.S.

Public Health Service recommended postponing initial

doses of the hepatitis B vaccine for up to six months in infants

whose mothers tested negative for the virus. Before then, the

vaccine routinely had been given to infants within 12 hours of birth,

regardless of whether a child's mother tested positive or

negative.

But concerns over a vaccine preservative called thimerosal, known to

contain mercury, prompted the change.

" The goal for any vaccine is to give it as early as possible and make

sure it is given before exposure to disease occurs, " says Dr.

Fiore, an epidemiologist with the Centers for Disease Control

and Prevention. " The change in recommendations was

largely in response to studies suggesting that even small levels of

mercury might be damaging to infants. "

Mercury-free vaccines became available within a few months -- as

early as September of 1999 -- but most hospitals haven't

changed back their policies, the CDC says. And, at least one infant

has died of the virus, in January of last year, the agency

says.

A CDC survey finds that 67 percent of hospitals surveyed have not

reinstated standing orders to administer the hepatitis B

vaccine at birth, according to a report in last week's Morbidity and

Mortality Weekly Report.

" The status quo didn't snap back the way we expected it to, " Fiore

says. " The lesson was that we need to be very careful about

vaccine policy changes because what occurs in actual practice may be

somewhat different from what's intended. "

A chronic infection that attacks the liver, hepatitis B is much more

dangerous for children than adults, Fiore says.

" The long-term consequence of being infected with [the virus] as a

young child is that 15 to 20 percent of people will die

prematurely of chronic liver disease and liver cancer, " he says.

Dr. Margaret Rennels, a land pediatrician and member of the

pediatric academy's committee on infection control, says the

decision to temporarily alter recommendations for infant vaccination

schedules was difficult.

" It was a very complicated decision, " Rennels says. " Everyone had

concerns that any change in the vaccine schedule would

lead to confusion, anger and probably missed doses. So, you've always

got to take that into consideration and weigh that

against the need for the change and the public's need to know about

it. "

The pediatricians' group is working hard, she says, to see that

hospitals return to previous infant immunizations

recommendations, using mailings, announcements on its Web site and

meetings nationwide.

But looking back, Rennels says she's not sure anything should have

been done differently.

" You just can't say we're not going to do anything about mercury in

vaccines, " she says. " It seems that the younger the child, the

more immature the child's brain and the higher the possibility of

brain damage from mercury -- so it made sense to withhold the

birth dose. "

What To Do

If you're expecting a child, it's always a good idea to get screened

for the hepatitis B virus. A vaccine will prevent your child

from contracting the virus during birth or later on from people who

unknowingly are infected with it.

" An important message to convey is that none of the current pediatric

hepatitis B vaccines have thimerosal in them, " Fiore says.

" So any concerns about mercury can be put aside now. "

To learn more about hepatitis B, check out information from the CDC.

For information on infant immunizations, visit the

American Academy of Pediatrics online.

Or, you might want to read previous HealthScout articles on hepatitis

or immunizations.