SmartVax Discussion on the HepB vaccine

Hepatitis B infection is an established cause of acute and chronic hepatitis and cirrhosis.  It  is spread primarily through unsafe sex or intravenous drug use.  However if a mother has a HepB infection, the fetus can be infected.  The Hepatitis B vaccine is administered to all USA infants at birth, 4 months, and 6 months because the vaccine can help prevent an infected infant from developing Hepatitis B disease.  In 2007 there was only a 1 in 480 risk of a live birth to a HepB-positive mother according to report ed cases (the CDC estimated that due to potential unreported cases, the risk could be as high as 1 in 216). [1] [2]

The HepB vaccine introduced in 1991 contained the known neurotoxins thimerosal (mercury preservative) and an aluminum adjuvant, and  HepB vaccines today still contain an aluminum adjuvant (see Does Aluminum cause Vaccine-Injury?).  The introduction of the HepB vaccine is aligned from a timing perspective with the shart increase in autism in the early 1990’s (see Autism Prevalence and Vaccine Introduction).  In 2009, a scientific study indicated that boys who received HepB vaccine had a 3x greater risk of developing autism, and a 9x greater risk of needing special education services.  A 2011 study found that the HepB vaccine changes gene expression, including the expression of seven genes that are biomarkers for liver injury (HERE).

In 2000 due to concern over mercury-containing HepB vaccines to new-born infants, the CDC temporarily stopped recommending the HepB vaccine for all infants.  Instead, they recommended that hospitals test the pregant women for HepB and only administer the HepB vaccine to the very small number of infants born to HepB-positive mothers. This sound policy, which matched what the schedules of many developed countries (such as the UK, Denmark, Netherlands, Switzerland, Sweden, Norway, Finland, Ireland, Iceland, and Japan) [3] [4], was ended by 2001 when the vaccine was routinely recommended again.

As discussed in Why Vaccinate a Baby for HepB?, the Hepatitis B vaccine may not benefit a newborn whose mother is not HepB-positive since immunity from the vaccine often wanes prior to the teen years [5].  A case could be made that the USA should again match the schedules of many other developed countries by no longer recommending Hepatitis B vaccines for infants unless the mother is HepB-positive.  A new-born baby that is only a few hours old may not have an immune system that is ready to handle the aluminum adjuvant and other components of this vaccine.  Pregnant women in the USA could request to be tested for Hepatitis B, and then to have the HepB vaccine administered to an infant only if the HepB test results are positive. This vaccine might instead be considered for administration during the teen years prior when an individual might be engaging in the activities that are risk factors (unsafe sex and illegal intravenous drug use).

 

[1] http://pediatrics.aappublications.org/cgi/content/full/111/Supplement_1/1192

[2] http://www.cdc.gov/nchs/data/nvsr/nvsr57/nvsr57_12.pdf

[3] WHO (2009). Progress towards global immunization goals. Geneva: WHO.

[4] Centre for Disease Control and Prevention. Global progress toward universal childhood hepatitis B vaccination, 2003. MMWR 2003;52:868-70.

[5] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2910296/