A Podful of Pediatrics

The One Where We Talk About Hep B

Episode Summary

Hepatitis B is a serious liver infection that often causes no symptoms in children but can lead to liver failure or cancer later in life. The good news? It is almost entirely preventable with vaccination. In this episode, we explain what hepatitis B is, how it spreads, and why infants and young children are at the highest risk for lifelong infection. We break down what happens when babies are exposed, why early infection is so dangerous, and how universal vaccination dramatically reduced hepatitis B in the U.S. We also walk through how the hepatitis B vaccine was developed, how it works, what side effects to expect, and why treatment is far less effective than prevention. Finally, we explain the recent changes to federal vaccine recommendations, what they mean for families, and why many pediatricians still recommend following the American Academy of Pediatrics schedule. Clear facts, real risks, and practical guidance to help parents protect their kids’ livers for life.

Episode Notes

Schillie S, Vellozzi C, Reingold A, et al. Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices. MMWR Recomm Rep 2018; 67:1.

Centers for Disease Control and Prevention. 2022 Viral Hepatitis Surveillance Report. 2024. Available at: https://www.cdc.gov/hepatitis/statistics/2022surveillance/index.htm (Accessed on July 23, 2024).

Chen HL, Chang CJ, Kong MS, et al. Pediatric fulminant hepatic failure in endemic areas of hepatitis B infection: 15 years after universal hepatitis B vaccination. Hepatology 2004; 39:58.

Sokal EM, Paganelli M, Wirth S, et al. Management of chronic hepatitis B in childhood: ESPGHAN clinical practice guidelines: consensus of an expert panel on behalf of the European Society of Pediatric Gastroenterology, Hepatology and Nutrition. J Hepatol 2013; 59:814.

Smith EA, Jacques-Carroll L, Walker TY, et al. The national Perinatal Hepatitis B Prevention Program, 1994-2008. Pediatrics 2012; 129:609.

Hoofnagle JH, Shafritz DA, Popper H. Chronic type B hepatitis and the "healthy" HBsAg carrier state. Hepatology 1987; 7:758.

McMahon BJ, Alberts SR, Wainwright RB, et al. Hepatitis B-related sequelae. Prospective study in 1400 hepatitis B surface antigen-positive Alaska native carriers. Arch Intern Med 1990; 150:1051.

Zhao H, Zhou X, Zhou YH. Hepatitis B vaccine development and implementation. Hum Vaccin Immunother. 2020 Jul 2;16(7):1533-1544. doi: 10.1080/21645515.2020.1732166. Epub 2020 Mar 18. PMID: 32186974; PMCID: PMC7482909.

Haber, P., Moro, P. L., Ng, C., Lewis, P. W., Hibbs, B., Schillie, S. F., Nelson, N. P., Li, R., Stewart, B., & Cano, M. V. (2018). Safety of currently licensed hepatitis B surface antigen vaccines in the United States, Vaccine Adverse Event Reporting System (VAERS), 2005-2015. Vaccine, 36(4), 559–564. https://doi.org/10.1016/j.vaccine.2017.11.079

Woo, E. J., Miller, N. B., Ball, R., & VAERS Working Group (2006). Adverse events after hepatitis A B combination vaccine. Vaccine, 24(14), 2685–2691. https://doi.org/10.1016/j.vaccine.2005.10.049

Lewis, E., Shinefield, H. R., Woodruff, B. A., Black, S. B., Destefano, F., Chen, R. T., Ensor, R., & Vaccine Safety Datalink Workgroup (2001). Safety of neonatal hepatitis B vaccine administration. The Pediatric infectious disease journal, 20(11), 1049–1054. https://doi.org/10.1097/00006454-200111000-00009

https://downloads.aap.org/AAP/PDF/AAP-Immunization-Schedule.pdf

https://substack.com/@yourlocalepidemiologist