Shots Snafu Puts Newborns at Risk
Hospitals urged to reinstate hepatitis B vaccine
By Jeff Kelliher
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.
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
concerns over a vaccine preservative called thimerosal, known
to contain mercury, prompted the change.
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. Anthony 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
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.
CDC survey finds that 67 percent of all hospitals have not
reinstated standing orders to administer the hepatitis B
vaccine at birth, according to a report in this week's Morbidity
and Mortality Weekly Report.
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
chronic infection that attacks the liver, hepatitis B is much
more dangerous for children than adults, Fiore says.
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,"
Margaret Rennels, a Maryland 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.
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."
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.
looking back, Rennels says she's not sure anything should have
been done differently.
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."
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.
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