I have 13 years of general Pediatric practice experience and an additional 12 years as a Pediatric Hospitalist in which I care primarily for newborns.
I’ve been asked every question you can imagine about immunizations. I’ve studied the literature and attended conferences to be sure that I am giving parents accurate information. I believe every child deserves the best of care and the safety of immunizations is as important to me as it is to parents.
The questions I’m asked most often are: “Why do babies get so many vaccines so early in life? Wouldn’t it be better to spread them out? Isn’t it too much for their immune system?”
Vaccines are offered at the earliest age at which they are proven to be both safe and effective. In the U.S., hepatitis B is the only vaccine offered before 6 weeks of life. The hepatitis B vaccine is as safe and effective in a newborn as it is in an adult.
There are other vaccines that we wish we could use in newborns, particularly the pertussis vaccine, but most vaccines can cause fever. Newborns with fever end up getting checked out for serious infections, so we hold off on those vaccines for safety reasons until 6 to 8 weeks. The hepatitis B vaccine rarely causes any fever and even one dose of the vaccine is 85 percent protective when there is a known exposure to the virus.
Why do we give hepatitis B vaccine so early? Hepatitis B is a blood and body fluid-born virus, much like AIDS virus. It is more common in the U.S. than AIDS, and unlike the AIDS virus, can live on surfaces for up to three weeks.
There are millions of copies of the virus in a teaspoonful of blood. About a third of people who catch hepatitis B don’t know where they got it from and about a third of those who have the chronic hepatitis B infection don’t know that they have it until they develop liver cancer or cirrhosis.
Newborns that catch hepatitis B most often develop chronic infection that causes liver failure or cancer in their teens or twenties. We can test all of our moms for hepatitis B, but we can’t test all of the dads, grandparents, babysitters, housekeepers, friends and relatives who the baby will come in contact with.
I once diagnosed a 13-year-old boy with chronic hepatitis B who caught it from his father who did not know he was a carrier until his son’s diagnosis.
The earlier we can vaccinate, the more diseases we can prevent. Delaying a vaccine that is proven safe and effective at birth is like waiting until your child gets older before you start using a car seat.
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