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We have arranged a large family trip to South Korea in a few
months, but just found out that SK has a very high rate of
Hep B (which apparently is 100 times more transmissable than
HIV and can lead to very deadly liver cancer) and that the
CDC recommends all travelers get the Hep B vaccine. No
problem, except that it takes 6 months for the full course
of vaccination, and we are going sooner than that. I have
read that there is an expedited schedule that provides some
protection, but isn't as complete as the full 6 month
schedule. So we have to decide whether to cancel our
tickets and postpone our family trip (which may upset our
in-laws, etc.) or to just go and risk it. We travel
regularly and I don't usually worry about getting sick, but
Hep B/potential liver cancer seems extraordinarily dire.
Have any BPNers had to deal with this? What did you do?
Should we stay or should we go?
You are right that Hep B is much more transmissible than
HIV. And a person become infected with Hep B the same way;
thru bodily fluids. So your risk of getting infected while
in South Korea depends a bit on what you do. If you do not
have sex with an infected person or do not need a blood
transfusion, then you will not have to worry about becoming
infected. If you really want to have all your bases
covered, find out the blood types of all your family and
that way if there is a medical emergency, someone can donate
the needed blood. Go and have fun!
Something to keep in mind is that Hepatitis B is not
transmitted casually -
http://www.hepb.org/hepb/transmission.htm -- which should
alleviate some concerns. Also remember that vaccinations
are not risk-free either. I developed a certain auto-
immune condition close in time to my Hepatitis B vaccines
(which I took because I was travelling to Korea) and if I
had to do it again, I would not take them.
I think you are over reacting. According to the CDC
Hepatitis B virus is not spread by sharing eating
utensils, breastfeeding, hugging, kissing, holding hands,
coughing, or sneezing.
...and here's the context that HepB ''is 100 times more
transmissable than HIV'':
Can Hepatitis B be spread through sex?
Yes. Among adults in the United States, Hepatitis B is
most commonly spread through sexual contact and accounts
for nearly two-thirds of acute Hepatitis B cases. In fact,
Hepatitis B is 50-100 times more infectious than HIV and
can be passed through the exchange of body fluids, such as
semen, vaginal fluids, and blood.
In other words, make your in-laws happy and go!
Hepatisis B is a very serious and deadly disease, but
similar to HIV, it is NOT - I repeat - NOT transmitted
So, unless you are planning on using unsterile needles,
having unprotected sex or anything that results in direct
blood-to-blood contact... I think you are OK. Definitely
would not warrant canceling a trip.
Educate yourself about the transmission of a disease
BEFORE worrying about receiving the diagnosis.
Someone who works with Hep B+ individuals
I'd like to know what information people have heard about the
Hepatitis A vaccine. Our pediatrician has brought it up to us a
few times, and each time I have declined, thinking this isn't
really an illness we'd be exposed to. Also, I've asked some
friends and their pediatricians haven't brought this up as part
of their children's routine care. But given the recent Hepatitis
A outbreak, I'm now more concerned. Are pediatrician's generally
recommending this? How long has it been out/what's the info. on
it? Thank you!
(Please note: I have given my children all their vaccines,
except for this and chickenpox, so this is not a post about the
pros/cons of vaccines.)
After college and before settling down, I traveled the world,
including to some places that had high incidence of Hepatatis
A. Before traveling to several places and while I was in some
regions, I had the dreaded (painful and not-too-long-lasting)
Gamma Globulin shot to prevent Hepatitis A. I would love my
children to travel as I did, without having repeated Gamma
shots. That is why I chose for my children to have the
Hepatitis A vaccine.
Our pediatrician did not recommended the Hep A vaccine as part of
standard care, but we did have our (then) 2.5 yr old
vaccinated because we travel frequently to Greece. That was 2.5 years
ago, and we've experienced no problems as a
result of the vaccine.
As a pediatrician, I recommend the Hep A vaccine but don't push
it the way I would some of the others that I feel very strongly
about. It is not required for schools. As a Californian, you
and your child are at higher risk for getting Hep A through
restaurant food, daycare, etc. (it can be passed through poor
handwashing--ie fecal-oral) just because the rate in this state
is higher than many other places. The disease can be nasty
(painful, hospitalizations) and sometimes fatal although it
doesn't usually result in death. The vaccine has very few side
(most people have nothing, a few get a day of poor appetite,
The Hepatitis A vaccine has been used routinely in California
for kids over 2 for several years (and prior to that has a very
long history of being used as a trav! el vaccine). One of the
reasons it has become a routine vaccine in California is that
Hepatitis A actually is quite common in California (though less
so, since using the vaccine). Hepatitis A had been more common
in the western states of the US, and many states in the east
hadn't been using it routinely (though if Pennsylvania wasn't,
they probably will now!) It still is around -- there was a
child with Hepatitis A in a daycare in Oakland a few months
ago. It's also very safe -- the only side effect is a headache,
but even that usually only occurs in adults.
For objective professional information readily available at a
click of your mouse...don't take it from me, see the web
information available from the US Centers for Disease Control &
Prevention (CDC). For example, to find information on the
hepatitis A vaccine follow the following trail:
The CDC ''Health Topics A to Z home page'':
Information about all immunization topics:
A ''quick reference disease chart'' for immunization information:
A vaccine ''information sheet'' for hepatitis A
I am a member of Kaiser, which only carries the multi-dose Hep B
vaccine that contains thimeresol. Does anyone know of a location/clinic
where their vaccine doesn't contain mercury and I can get the vaccine
for my (almost) 2-year old, and you don't have to be a member? I'm not
looking for a discussion about vaccines or thimeresol, I just need to find
a provider or place where I can access the Hep B vaccine without this
preservative. I am willing to pay for the vaccine, if necessary.
Thanks for the help.
Are you sure it has thimerosal? Our Kaiser pediatrician told us
that all the children's vaccines they use, except flu, are
This past Friday, my family and I were watching 20/20 and became very interested in the series discussing children and the Hep B shot. Apparently several young children reacted badly to the immunization and some even died. Although the doctors that spoke for the immunization shot, explained that those children who had a bad reaction did so for specific and unusual circumstances. I am still concerned for the well being of my son.
So far, he has received his two first doses of the shot, and in February he is due for his third. He had no reaction to the first two, just the typical pain around the area and a slight fever. I realize that all schools require children to be up to date with their shots (which he is), but I am interested in first finding out what are possibilities for my son to have a bad reaction. For many years, I've had no doubts on what my son's Pediatrician recommended for him. But now I am wondering if maybe I should be a bit more stern and ask lots of questions. Can any parent provide me with any information on where I can do more research on this issue? Or if any parent can share their experiences with this issue I would really appreciate it? Maybe I am overreacting, but I can't be too careful with my son's health. Thank you!
I thought the message below might be of interest to the parent who
expressed concerns about the Hepatitis B vaccine. Apparently, many are
quite outraged about that 20/20 segment and feel it unfairly casts
suspicion on the vaccine. Laura
For those continuing to follow this thread, the news story on
hepatitis B vaccine did air on ABC's 20/20 News Program on Friday,
January 22, 1999.
As anticipated it presented anecdotal reports of individuals who
suffered coincident illnesses, syptoms, or death near, and in some not
so near, to the receipt of a dose of hepatitis B vaccine. A molecular
biologist, Dr. Bonnie Dunbar, Baylor College of Medicine, was also
featured expressing concern about adverse events as she observed immune
problems develop in a relative and others following vaccination.(1)
The reporter who presented this segment, Sylvia Chase, questioned the
logic of universal HB immunization strategy in lieu of reports of
adverse reactions occurring temporally with administration. The
broadcast portrayed universal coverage as an unnecessary intrusion from
More on this is available from ABC's web site at the following URL
Other reports continue to appear since the 20/20 broadcast as Reuters
has posted an article, "Hepatitis B vaccine in children questioned"
which is available at:
These reports will likely generate questions by the general public and
health care workers which can be answered by pulling in resources
provided earlier to the list from the CDC web site.
In the US each year 4,000-5,000 deaths are attributed to hepatitis B
infection, 130,000 cases of new HBV occur annually, and 1.25 million
people have chronic HBV. The World Health Organization(WHO) further
estimates global prevalence of 350 million chronic carriers of HBV and 1
million deaths/year. One question raised is why universal immunization
in countries with relatively low endemicity? Van Damme, Kane and others
from the WHO have answered this by pointing out " the incidence of new
infections and the burden of acute and chronic disease place hepatitis B
among the most important communicable diseases...mortality from HBV was
five times that from _H. influenzae type B_and 10 times that from
measles before routine vaccination of children was introduced."
(2) Van Damme and others go on to point out the failure of
immunization campaigns aimed only at "high risk groups".
Adverse events such as multiple sclerosis, rheumatoid arthritis, and a
number of other intercurrent conditions have been alleged to be
associated with receipt of HB vaccine. Under scientific scrutiny none
of these holds up; save for rare episodes of anaphylaxis these vaccines
are very safe and effective.(3-5) Instead there is misinterpretation of
reports in the U.S. Vaccine Adverse Event Reporting System(VAERS) as
demonstrating causality - this system incorporates all reports which are
confounded by its passive nature and is not intended to establish
Last, the following was just published in MMWR, which may, in part, be
prompting all the attention on this vaccine. This remains the correct
strategy, in my opinion.
"Update: Recommendations to Prevent Hepatitis B Virus Transmission
United States," was published as a "Notice to Readers" in the January
22, 1999, issue of the MMWR. available at:
1. Marshall E. A shadow falls on hepatitis B vaccination effort. Science
1998;281(31 July): 630-1.
2. Van Damme P, Kane M, Meheus A, et al. Integration of hepatitis B
vaccination into national immunization programmes. BMJ
3. Niu MT, Rhodes P, Salive M, et al. Comparative safety of two
recombinant hepatitis B vaccines in children: data from the VAERS and
VSD. J Clin Epidemiol 1998;51(6):503-10.
4. WHO. Expanded programme on immunization(EPI). Lack of evidence
that hepatitis B vaccine causes multiple sclerosis. Weekly
Epidemiological Record 1997(23 May);72:149-52.
5. Lemon SM, Thomas DL. Vaccines to prevent viral hepatitis(review).
N Engl J Med 1997;336(3):196-204.
Russell N. Olmsted, MPH,CIC
Epidemiologist, Infection Control Services
Thomas G. Robins, MD, MPH
of Occupational Medicine,
University of Michigan
School of Public Health
Department of Environmental and Industrial Health
1420 Washington Heights
Room M6007 SPH II 2029
Ann Arbor, MI 48109-2029
I've spent some time researching the Hep B vaccine. It's the one vaccine
I did't have done on schedule for my daughter who is now 2 years old. I
too was alarmed by the 20/20 story. After much agonizing deliberation, I
have decided to claim a philosophical exemption to the vaccination
requirements which is allowable by law under the California Public
health Code. From what I've read, since widespread use of the vaccine
is relatively new (15 years or so) and adverse reactions that have
occurred are usually reported within a few days after the administration
of the vaccine, it's hard to determine the possible long term negative
effects. Many people (several nurses who were vaccinated as adults) now
have MS like symptoms and auto-immune responses which they feel (but
cannot prove)are related to the vaccine. A very interesting and credible
web site to check out is: hhtp://aspin.asu.edu/msnews/dunbar.htm. There
are several "pro vaccination choice" sites on the web. Unfortunately I
didn't bookmark them ,but a search under Hep B vaccine will turn them
up. As a health care worker, I have seen people die from diseases
resulting from chronic active hepatitis B. It's a terrible disease, but
from what I have read, the chances of my daughter having a bad reaction
to the vaccine are greater then her getting the disease (which is spread
in the same ways that AIDS is spread...although it is much more
contagious.....but unlike HIV, most people recover from Hep B.) The
vaccination was banned in France except for newborns. French scientists
believe there is an association between beginning the vaccine after 2
months of age and developing diabetes.
While I think a strong public health case can be made for the Hep B.
vaccine, certain individuals could possibly be at higher risk for
complications. What tipped the scales for me is that both my husband and
I have auto immune diseases and my daughter already has some pretty
severe allergies and a condition which may be auto-immune related.
Although CDC and other public health organizations claim the vaccine is
safe, all the anecdotal horror stories give me pause
and I would like to see these cases be thoroughly studied before I
subject my daughter to possible risk.
Incidentally, the manner in which the vaccine was researched and
developed is often used as a case study in medical ethics text books
Institutionalized mentally retarded children in New York were injected
with live virus to give them the disease!
The vaccination was banned in France except for newborns. French
scientists believe there is an association between beginning the vaccine
after 2 months of age and developing diabetes.
Could the person who
posted this please elaborate as to when it was banned?
As of late July '98, when I read an article in L'Express about the
vaccine,it was being routinely given to middle-schoolers in France, and
government officials were saying that the risks of adverse effects from
the vaccine were many times lower than the risk of adverse effects from
contracting the disease.
The following is from http://www.909shot.com
"In October 1998, France became the first country to end hepatitis B
vaccination requirements for school children after reports of chronic
arthritis, symptoms resembling multiple sclerosis and other serious
health problems following hepatitis B vaccination became so numerous
that the Health Minister of France suspended the school requirement."
There was a much more extensive website about the French ban but I
unfortunately could not find it again. If you have any other information
regarding the vaccine or whether or not it was indeed banned in France,
please post it.
The word from France is at:
In French, of course. My French is a little weak, but I think M.
Kouchner is saying "vaccination remains recommended for babies,
adolescents, and adults at risk." I would love to see a more complete
To confirm John's translation: yes, your translation is correct.
Sorry I don't have time to do a complete translation, but I did want to
add that the reason why the French gov't still recommends vaccinating
newborns is twofold:
1) there is no evidence of the vaccine causing neurological damage in
children under 5 (however, I didn't read this closely enough to
determine whether they were referring to children vaccinated before age
5 or children under age 5 showing symptoms of neurological damage).
2) they didn't want to discourage universal vaccination.
Most preschools require a list of immunizations which conforms
with the list of immunizations that are required by the state law -
including hepatitis B. What most preschools don't tell you: you can
ask for an extra form where you sign that for personal reasons or
something like that you don'n want to have immunized your child
and that you will take the entire responsability of the health of your
child which in fact you do anyway.
We had decided not to have the Hepatitis B shot for our son and
when we came to California for one year we did not want to revise
our decision just get our son into a preschool. So we were happy
to solve the issue just by a signature. In our opinion,
immunizations are a very difficult and personal decision. Get as
much information as you can and decide then. Consider possible
allergies, personal situation, time needed to take care of a sick
child, risks of infections, overseas-trips et cetera.
Does anyone out there have any experience with Hepatitus C and
any form of treatment, conventional or otherwise. My sister
has been diagnosed with this ddisease,probably the result of a
blood transfusion in the late 70s. She is terrified of the
conventional treatment which is interferon, yet she is afraid
to rely on alternative approaches, and has no information about
alternatives. The doctor says the treatment has only a 50-60%
chance of working. Yet she has been told that with not doing
anything there could be anywhere from a 10 to 33% chance of
serious damage to her liver. My sister has no liver damage so
far, and no symptoms,except that her few muscle and joint aches
could possibly be symptomatic for her. (She is 56 years old.
As her 55 year old sister without Hepatitus, I have LOTS of
muscle and joint aches.) We would appreciate any insights or
helpful information that would help my sister decide how to
treat her illness.
My younger sister has had Hepatitis C for a number of years. She
had quite a bit of liver damage prior to the current treatment
method of using interferon, and she was in line for a liver
transplant. About 2 years ago she participated in a study using
interferon. It made her quite ill; she said it was like having
the flu for months, and she had to take off from work whenever
she was doing the interferon treatments. She is the director of a
non-profit in Arkansas. But it really worked. She's had a clean
bill of health at all of her checkpoints the last 2 years. There
is always the chance that things may change, so she will have to
keep up with the twice-a-year checks all her life, but she feels
great and is able to work and be productive. She said the
interferon was pretty bad but the alternative is much worse. If
you want, send me email and I can put you in touch with her.
I have both hepatitis C (HCV) and type 1 diabetes. I have decided to not
do any conventional treatment for the HCV. With type 1 I have to pay
attention to what I eat etc., so that works well for the HCV as well. Most of
the time I feel healthy, I don't have any symptoms of liver disease, and
my test results are normal or close to normal for both conditions. Not
drinking alcohol is critical - so your sister would benefit from doing that
(I'm sure her doctor told her). From what you've said, it seems that doing
the conventional medical treatment would most likely cause more harm
than benefit (since there are so many serious side effects). It is an
individual choice, one that is difficult to make, but once I made it, I was at
peace with it. Most peoplewho have HCV die with it, not from it. It can be
quite serious, but given your sister's situation, as long as she continues
to take good care of herself, it is likely that it will never be a major
problem. (I'm not a doctor, I'm only speaking from personal experience.)
Your sister needs to decide what is best for her with the advice of a good
doctor. Alternative treatments like massage, chiropractic, and
accupuncture can be very helpful. The biggest hurdle is dealing with the
emotional issues related to having a chronic condition. I've found that
psychotherapy has been the most helpful treatment of all.
There is a great website and free manual called ''Hepatitis C:
Choices'' about the different treatment options for Hep C.
(western med, chinese med, homeopathic, etc.)
or http://www.hepcchallenge.org and click on the free download.
(I think acupuncture and herbs can treat Hep C.)
I have a very good family friend that has Hep C from transfusion
as well (Hemophelia). He started the interferon last year and
before the treatment was through had no trace of hep C (He is
also HIV+)!! He wouldn't be considered free and clear until 6
months after last treatment but that just passed and he has been
classified as Hep C free!! He was VERY fortunate and had no side
effects, this guy swims the bay every day, very healthy and was
able to maintain that lifestyle while going through the
I also have three family members that do weekly interferon for
MS. One cousin says that she has mild to moderate side effects
the saturday after she takes the shot (every Friday afternoon).
All of my relatives state that the side effects are mild enough
that ibuprophen works.....
HEP C is a serious concern....as a nurse, i had an HIV+/HEP C positive needle stick,
back before the ''cocktail'' of meds was available for HIV. i was much more
concerned with the HEP C part than the HIV part
I'd seriously consider the Interferon if it were my experience. Get a second opinion
or a third of a virologist/immunologist.
Blessings for and to your friend
I have some experience with Hepatitis C. It's a disease that
kills some people (usually those who engage in high risk
behaviors over long periods of time) while others can have it for
decades, never experience a symptom, live a long life, and die of
completely unrelated causes. The fact that your sister has no
detectable liver damage and few, if any, symptoms is great news.
I was told that I had Hep C after I donated blood about 5 years
ago. I was experiencing no symptoms at all. A liver biopsy
revealed some scarring in my liver. My gastroenterologist said
that because the scarring was not severe, some docotors might say
wait, do another biopsy in five years and see if the damage gets
worse. However, he recommended that I do the combination
interferon & ribaviron treatment, and I went ahead with it. I
stuck with it for the full 48 months, and it was successful. The
treatment was grueling and I have since come to understand that
the success rate reflects the fact that many people start the
treatment and do not finish. A small number of folks do not
respond at all; since they monitor your blood monthly, this is
discovered early on. I ended up having to take 9 months off from
work, including 3 after the treatment was done. Fortunately, I
had disability insurance, and my husband was able to really step
up his childcare role (he took sole responsibility most of the
time). So there's the good and the bad of my experience.
I assume that your sister has seen a specialist since she must
have had a liver biopsy to determine that she has no liver
damage. Based on what my doctor told me, my guess is that my
doctor would recommend that your sister wait and check her liver
in a few years. She may be one of those who can live symptom-free
for the rest of her life. On the other hand, I think it's
probably better to go through the treatment when one is younger
vs. older. If she chooses the treatment, I recommend that she try
to arrange for disability insurance and a lot of support,
particularly with childcare if she has young children.
Best of luck.
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