Let the discussion begin

So, I've been hesitant to post about vaccines for a few reasons:
1- because I know what a controversial topic they are, and both sides of the debate can get quite heated.
2- because I have so much information about vaccines that it is hard for me to organize it in my head, much less in a blog post.
3- I'm not sure that the few of you reading my blog have much desire to learn about vaccines.

That said, I do feel passionately about the importance of making educated vaccine decisions, and I wish I'd had more information when Amira was a baby. Let's start the discussion with the first vaccine babies are given: hepatitis B.

Hepatitis B is a serious disease, I am certainly not going to argue against that. It is a disease that affects the liver, and according to the CDC website is more likely to lead to an acute infection in adults and a chronic infection in infants and children. Children who develop chronic Hepatitis B can eventually die as a result of liver failure.

After listing the dangerous symptoms of HepB, the CDC lists the means of infection for the disease. Not surprisingly, they are not as thorough, or explicit, when they discuss the means of transmission:

A person can become infected by:
- contact with a mother’s blood and body fluids at
the time of birth; (this should read: contact with a HepB carrying mother)
- contact with blood and body fluids through
breaks in the skin such as bites, cuts, or sores; (translation: for your child to get HepB in this manner the blood or semen of a person with HepB would have to come in contact with an open sore on your child)
- contact with objects that could have blood or bodyfluids on them such as toothbrushes or razors; (don't let your baby brush their teeth with a HepB infected toothbrush. No shaving, either)

and, we vaccinate babies against these other frightening possiblities:
- having unprotected sex with an infected person;
- sharing needles when injecting drugs;
- being stuck with a used needle on the job.

Obviously,the italics were added by me, but the bullet points are all courtesy of the CDC's HepB vaccine sheet.
Just to be clear, HepB is a sexually transmitted disease, and is passed along by the same means as HIV. To be fair, HepB is viable outside of the body for longer periods than HIV, making it a bit more likely to contract (if a pool of HIV infected blood is sitting on your kid's toothbrush the virus will die more quickly than HepB, which can live outside of the body for a long time).

So, has the CDC lost their mind? Is that the point I'm trying to make here? Not at all. Although most of the ways to become infected by HepB are clearly not relevant to newborn babies, it is true that babies born to mothers with HepB can contract the disease during the birth process. If a baby is exposed to HepB during birth and is vaccinated for the disease immediately after, it can keep the newborn from contracting the disease. Clearly this a great idea and well worth the risks of the vaccine.

I imagine the large picture for the CDC employees in charge of immunizations looks something like this: a mother with hepatitis B can pass it on to her baby during childbirth. Vaccinating the at-risk newborn is an effective way to prevent the spread of this serious disease. It is not feasible to give the vaccine to only the babies of at-risk women (you can't very well say to a pregnant woman, "you look like you may be a promiscuous drug-user, we would like to vaccinate your child") so in the interest of protecting the at-risk babies, it is advisable to vaccinate all newborns against hepatitis B. This is where the problem lies, for me. (as a side note, I don't know why they can't test pregnant women for hepatitis B and only vaccinate the babies at-risk? They already test for HIV during pregnancy. Just a thought.)

I do not have hepatitis B. As a monogamous, drug-free, non health-care worker I know I am not at risk for getting hepatitis B anytime soon. Because of that I would like to make the argument that is not only unnecessary, but ludicrous(and even dangerous), to suggest that I should have vaccinated my just hours-old infant against a sexually transmitted disease.

At Norah's 2-month appointment I discussed this issue with her pediatrician:
me: I really don't understand why someone as low-risk for getting the disease as my 2-month old should have to get a vaccine.
Doctor: There are other many ways Norah could get HepB.
Me: What kind of things should I be worried about?
Doctor: She could be infected by needles or by other bodily fluids in a daycare setting.
Me: (not believing the conversation has gone on this long) My daughter doesn't go to daycare. She just doesn't have any contact with needles or infected bodily fluids (read:semen). Are there other things I should worry about.
Doctor: mumbles a few things, starts to discuss other vaccines.

I would like to say that I actually really like my pediatrician, and appreciate her openness to some of the information I have. I know she is under a large amount of pressure to encourage vaccines.

One final point, and then I should probably go back to taking care of my kids :) I recognize that vaccines are not only about protecting the individual child, but protecting the community, at large. I appreciate that need, and consider "herd immunity" very strongly when making my vaccination choices. Due to the fact that hepB is an STD (have I beaten that point to death) concerns about un-vaccinated Norah infecting someone else are minimal.

I haven't mentioned any of the possible side effects for the hepB vaccine (of which, sadly, there are many) because I think the arguments against the vaccine are strong enough, on their own. Any risks of the vaccine are too many, in my mind, since the vaccine is not at all necessary for low-risk children, in the first place.

I can't help but post one last section from the CDC's website that illuminates, once more, the risk factors for hepB:

All unvaccinated adults at risk for HBV infection
should be vaccinated. This includes:
- sex partners of people infected with HBV,
- men who have sex with men,
- people who inject street drugs,
- people with more than one sex partner,
- people with chronic liver or kidney disease,
- people with jobs that expose them to human
blood,
- household contacts of people infected with HBV,
- residents and staff in institutions for the
developmentally disabled,
- kidney dialysis patients

According to Dr. Robert Sears (from his book called The Vaccine Book, in which he actually recommends the importance of most of the vaccines) Dr. Sears advises against giving your baby the hepB series unless you have "one risky baby." My point, exactly.

ps- I am constantly learning in this aspect of parenting, as in all others, and am very much open and grateful for additional information. If you have information to refute or support my assertions, I would greatly appreciate your input.