1 in 5 At-Risk U.S. Babies Doesn't Get Hepatitis B Vaccine

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At-Risk U.S. Babies Doesn't Get Hepatitis B VaccineResearchers urge hospitals to

vaccinate all childrenBy Jenifer GoodwinHealthDay ReporterMONDAY, March 8

(HealthDay News) -- About one in five babies born to mothers with hepatitis B

aren't getting treatments that have been shown to prevent the infection in

newborns, a new study finds.Given within 24 hours of birth, the hepatitis B

vaccine and hepatitis B immunoglobulin can protect 85 percent to 95 percent of

newborns from becoming infected, even if they were exposed at birth.Researchers

from the U.S. Centers for Disease Control and Prevention reviewed medical

records of 4,762 mothers and 4,786 infants. The records represented about 25

consecutive live births from 190 U.S. hospitals, each of which was surveyed

about their hepatitis B prevention policies in their labor and delivery

departments.Records showed that 18 women tested positive for hepatitis B at the

time of admission to the hospital. While 62 percent of their newborns received

the hepatitis B vaccine and immunoglobulin, nearly 14 percent left the hospital

unvaccinated and nearly 20 percent did not receive immunoglobulin before

discharge, according to the study.Of 320 women whose hepatitis B status was

unknown, meaning they may or may not have been tested for the virus, only about

52 percent of their infants were vaccinated within 12 hours of birth. About 20

percent of these babies left the hospitals without being vaccinated. " A key

message of the study is that hepatitis B virus transmission is almost entirely

preventable through vaccination and prophylaxis, " said study author Bayo Willis,

a CDC epidemiologist. " We really need hospitals to have correct policies in

place and to implement those policies so that every newborn is protected before

they leave the hospital. " The study findings were released online March 8 in

advance of publication in the April print issue of Pediatrics.About 1.4 million

U.S. residents have chronic hepatitis B infection, which causes from 2,000 to

4,000 deaths annually. Children can become infected during delivery or from

household contact with those who are infected, according to background

information in the study. The virus spreads through blood or other body

fluids.While many people who contract hepatitis B are able to eventually clear

their bodies of the infection, some develop chronic hepatitis, which eventually

can lead to cirrhosis and liver cancer.Children are even more vulnerable to the

disease. About 90 percent of children who contract hepatitis B go on to have

chronic infections, many of whom will have liver disease by the time they're in

their 20s, said Dr. Bromberg, chairman of pediatrics and director of the

Vaccine Research Center at The Brooklyn Hospital Center. About 25 percent of

them will die prematurely, according to the article.The CDC recommends infants

receive the hepatitis B vaccine at birth, and then receive booster shots at one

and six months.Pregnant women should also be tested for hepatitis B as part of

their prenatal care, which is something not all women receive. In those

situations, women should be tested upon admission to the hospital, Bromberg

said.Not all hospitals do so routinely, however. Only 67 percent of hospitals

had a policy calling for all newborns to receive the hepatitis vaccine, while 63

percent of hospitals said they had a policy of testing women upon admission if

there was no documentation of a hepatitis B test.Nearly 81 percent of hospitals

said they would give exposed infants the hepatitis B vaccine within 12 hours and

about 77 percent said they would give the immunoglobulin within 12 hours. " The

more the hospital paid attention, the better the outcomes were, " Bromberg said.

" The fact that only about 73 percent of hospitals even look at the results of

the hepatitis test is pretty atrocious. That means 27 percent of hospitals don't

even look. " In addition, researchers noted documentation errors in the medical

records regarding mothers' hepatitis B status, such as the mother's record

noting she had hepatitis B but the same information was not included in the

infant's record.Each year, about 40 to 90 cases of perinatal hepatitis B are

reported to the CDC, although the true number may be 10 to 20 times that,

according to researchers. " The greatest predictor of which children would get the

hepatitis vaccine was the hospital having a policy for universal vaccination of

infants, " Willis said. " Our study shows that gaps still persist in perinatal

hepatitis B prevention. " More informationThe Hepatitis B Foundation has more on

the vaccine.SOURCES: Bayo Willis, M.P.H., epidemiologist, U.S. Centers for

Disease Control and Prevention, Atlanta; Bromberg, M.D., chairman,

pediatrics, and director, Vaccine Research Center, The Brooklyn Hospital Center,

New York City; March 8, 2010, Pediatrics, online HealthDay. All

rights reserved.