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On August 28, 2017, the American Academy of Pediatrics (AAP) called for the administration of the hepatitis B vaccine to all American newborns within 24 hours of birth. This decision shows that the AAP is completely incapable of performing a risk-analysis, that they don’t know the basics of germ-theory, and that they don’t even give lip-service to individualized medicine.

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Diseases, including vaccine-preventable diseases like hepatitis B, are caused by exposure to pathogens. Simply put, you cannot get a disease if you are not exposed to its pathogen — it’s germ-theory 101. Hepatitis B is caused by the hepatitis B virus, so if you are not exposed to the hepatitis B virus, you cannot get that disease. Hepatitis B is NOT caused by a lack of hepatitis B vaccination. A hepatitis B vaccine can train your immune system to attack and resist hepatitis B virus if it is exposed to it, but you still can’t contract it unless you are exposed.

According to the US Centers for Disease Control (CDC):

HBV is transmitted through activities that involve percutaneous (i.e., puncture through the skin) or mucosal contact with infectious blood or body fluids (e.g., semen, saliva), including

  • Sex with an infected partner
  • Injection drug use that involves sharing needles, syringes, or drug-preparation equipment
  • Birth to an infected mother
  • Contact with blood or open sores of an infected person
  • Needle sticks or sharp instrument exposures
  • Sharing items such as razors or toothbrushes with an infected person

The ONLY one of the risk-factors listed above that should apply to an infant is being born to a mother who is infected with the hepatitis B virus. All infants that are born to mothers with the hepatitis B virus should get the hepatitis B vaccine. However, according to the CDC, only 1,000 of the 4,000,000 infants born in the U.S. each year are born to mothers with hepatitis B. That means that only 0.025% of American newborns are at risk of acquiring hepatitis B from their mother.

So, why is the AAP calling for ALL infants to be vaccinated against hepatitis B regardless of the viral status of their mother? Why is the AAP calling for an invasive medical procedure to be performed on ALL infants when far fewer than 1% of American-born infants are at risk of exposure to the virus?

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I think it’s an absurd recommendation, but in an attempt at empathy, I’ll give you a couple potential reasons why an organization of presumably smart people might make a recommendation along these lines:

  1. They think that the hepatitis B vaccine is harmless, and that we “may as well” give it to all infants “just in case” they’re exposed to the disease.
  2. Greed, greed, and more greed. Pediatricians are paid to “fully vaccinate” the children in their practice. Pediatrics is not the highest paying medical specialty, and recommending over-vaccination is a way that the AAP can financially support its members.
  3. They don’t have the time or resources to ask about every mother’s hepatitis B status, so they assume that everyone is hepatitis B positive (even though very few people are).
  4. “The AAP justifies the ridiculous extremity of vaccinating everyone’s children, regardless of hepatitis B status, on the day of their birth, with the fact that approximately 90% of infants who contract perinatal hepatitis B (there were 37 infants who contracted perinatal hepatitis B in the U.S. in 2015) would go on to develop chronic hepatitis B infections in the absence of treatment. That chronic hepatitis B in combination with cirrhosis (much more likely with high levels of alcohol consumption) could put those children at significant risk of liver cancer someday. In other words, the AAP is telling us that we all need to vaccinate our newborns immediately to keep them from being among the 33 infants per year who could drink themselves into liver cancer someday.” (source)

Possibility #1 is likely the one that resonates most with parents of newborns, while possibilities #2 and 3 are self-explanatory, and possibility #4 is just ludicrous. When most parents agree to have their newborn vaccinated against the hepatitis B virus on the day of their birth, they are attempting to protect their child. They think that the possibility of being exposed to the hepatitis B virus is high, and the possibility of suffering from an adverse-reaction to the hepatitis B vaccine is low to non-existent. Is that true though?

Again, per the CDC, the activities that put a person at-risk for exposure to the hepatitis B virus are:

  • Sex with an infected partner
  • Injection drug use that involves sharing needles, syringes, or drug-preparation equipment
  • Birth to an infected mother
  • Contact with blood or open sores of an infected person
  • Needle sticks or sharp instrument exposures
  • Sharing items such as razors or toothbrushes with an infected person

Don’t let your infants have sex with anyone — much less an infected partner, don’t let them inject drugs, don’t let them have contact with blood or open sores of an infected person (typically IV drug users and sex workers), and tell them not to share toothbrushes or razors with anyone. That’s parenting 101.

Yes, there are horrible situations that can happen — a child could get raped by a hepatitis B infected person, or a dentist could fail to clean her tools properly and infect your child with hepatitis B (or HIV). These things could happen. But they are incredibly unlikely, and they are even less likely when a child has parents who are desirous of keeping him or her safe.

But the vaccine is completely, 100%, unassailably, infallibly, safe, right? No, of course not. No pharmaceutical, medical device, or vaccine is perfectly safe for everyone. Every single medical intervention has “side-effects” — including vaccines. They may be “rare” but they are not impossible. Your child may have an immune-system disorder, kidney disorder, liver disorder, or genetic predisposition that makes him or her unable to properly process the hepatitis B vaccine, and he or she may suffer from an adverse reaction to it. Additionally, vaccinating on the day of a child’s birth makes it impossible for parents and physicians alike to know whether or not an infant is healthy, or whether his or her immune system, kidneys, liver, etc. are operating as they should.

How likely are adverse reactions to the hepatitis B vaccine given to infants on the day of their birth? That’s a tough question to answer. It’s difficult to tell when an infant is having an adverse reaction to a vaccine given to him or her at birth. Neither parents nor pediatricians have any notion of what is “normal” for that particular baby. If the baby is crying incessantly, it may be having a bad reaction to the vaccine, or it may just be a fussy baby. Vaccinating on the day of birth means that there is no baseline of health for the baby.

Since one can’t do a before/after test of an infant that receives a hepatitis B vaccine on the day that infant is born, we must look toward epidemiological studies to give us an idea of the risks of the hepatitis B vaccine. Epidemiological studies point toward increased incidents of neurological problems for children who receive the hepatitis B vaccine at birth.

A 2007 study found that odds of requiring early intervention services for developmental disabilities were nine times greater in boys who had received three doses of hepatitis B vaccine than in boys who had received zero. A 2010 study found that boys who received the birth dose of hepatitis B had a threefold risk of autism when compared with boys who didn’t.

Neurological problems in children are far more common than perinatal hepatitis B transmission. Approximately 11% of children ages 4-17 have been diagnosed with ADHD (also according to the CDC), and 1:68 children are on the autism spectrum. The chance of hepatitis B transmission at birth is less than 1%.

Which do you think is more likely, that your child is going to be exposed to hepatitis B (whether from a rapist IV drug-user, or from a negligent dentist, or from you) or that he or she is going to have a neurological disorder? Basic math and commonsense tell you that a neurological disorder is more likely. Certainly, there are other causes of neurological disorders, but vaccination for hepatitis B at birth is linked to neurological disorders, and even if it being a causal agent is truly rare, it’s still more likely than encountering a negligent dentists, or a drug-addicted, hepatitis B infected, rapist attacking your infant — at least for most people.

Even if you dismiss all evidence linking administration of the hepatitis B vaccine at birth to later neurological problems, the chances of hepatitis B infection of an infant born to a mother who is not infected with hepatitis B are so slim that it’s not even worth the pain caused by the jab itself, much less the aluminum adjuvants, intentional immune system activation (that is what vaccines are intended to do), and other side-effects of the vaccine.

The AAP recommendation that all infants be vaccinated against hepatitis B on the day of their birth is absurd. A risk-analysis using data and information directly from the CDC shows that children born to uninfected parents are unlikely to be exposed to the hepatitis B virus, and though the risk of experiencing an adverse reaction to the vaccine is difficult to establish, there are certainly reasons to think that adverse reactions are more likely than hepatitis B virus exposure.

One of the more offensive and obnoxious things about the AAP recommendation is that it doesn’t take into account any individual differences in disease-status or lifestyle. Neither I, nor the AAP, know the risk factors in your life, and I encourage everyone who has children, or even who is thinking of having children, to do their own risk analysis before taking any medication, or accepting any vaccination.

We don’t routinely vaccinate against yellow fever in the U.S. because yellow fever is a tropical disease that doesn’t exist in the U.S., and therefore it is not necessary for us to vaccinate against it unless we’re travelling to a place where it does exist. Hepatitis B exists in the U.S., but it is rare, and vaccinating every infant against it, on the day of their birth, is crazy. It’s disappointing that an organization like the AAP, that is presumably full of intelligent people, is advocating for it as a routine practice.

I’m sure that there will be many disparaging comments and accusations of being an “anti-vaxxer” thrown in my direction, but just to make sure that I make everyone on both sides of the vaccination fence mad, I want to close by saying that I’m not opposed to the hepatitis B vaccine. If you are engaged in high-risk activities, such as IV drug use or unprotected sex with various partners, getting vaccinated against the hepatitis B virus is smart and responsible. Infants who are born to mothers who are infected with the hepatitis B virus should receive the hepatitis B vaccine. However, it is absurd to vaccinate every infant, regardless of risk, against a sexually transmitted disease that he or she has close to zero risk of exposure, on the day of his or her birth. Every pharmaceutical, including every vaccine, has risks, warnings, and contraindications. Exposure of every infant born in the U.S. to those risks, is ridiculous, thoughtless, and wrong. The AAP has made a recommendation that is somewhere between thoughtless and negligent, and they should rescind and change course.

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