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Excerpted from "Immunization and Infectious Disease News"
Wisconsin Whisper
July 2001

Tom Saari, MD, FAAP
  

Hepatitis B Birthdosing: The unthinkable has happened in Wisconsin and Minnesota. One infant in Milwaukee and 6 newborns in Minnesota were born to hepatitis B surface antigen positive mothers who were misidentified either as HBsAg negative or whose HBsAg status was initially unknown at delivery. None of these infants were afforded the recommended hepatitis B vaccination or HBIG at birth. In fact , the Milwaukee infant failed to receive any hepatitis B protection until after 10 months of age because the family was lost to follow up for lack of an identifiable primary care provider. This infantís most crucial chance for protection from becoming a chronic hepatitis B carrier and a subsequent fatality statistic was lost in a birthing hospital that had decided to suspend the routine hepatitis B birthdose following the thimerosal alert 2 years ago.

This game of Russian roulette that 40% of the 98 Wisconsin birthing hospitals that no longer offer routine hepatitis B vaccine birthdosing are playing will, with certainty, have a deadly outcome. And with bad, preventable out comes, law suits will surely follow. Like Wisconsin, the State of Minnesota Health Department has issued a call to all Minnesota birthing hospitals to resume routine hepatitis b birthdosing It became clear that many more infants were falling through the cracks of maternal testing snafus in Minnesota than originally thought and there is no reason why the situation in Wisconsin should be any different.

Remember, the Wisconsin DHFS will provide hepatitis B vaccine FREE to any Wisconsin birthing hospital that signs up through the VFC program to give hepatitis B vaccine to all their infants before discharge. Every Wisconsin infant , regardless of their insurance or HMO status, can receive hepatitis B vaccine prior to discharge at no cost. Current combination vaccine use should not deter you from giving hep B vaccine at birth. There also appears to be a significant increase in hepatitis B serologic titers (>3 fold) when hepatitis B birthdose is given in conjunction with combination vaccines containing hepatitis B.

I have a Power Point outline detailing the rationale and advantages of providing hepatitis B vaccine as a universal birthdose that I can e-mail to you as an attachment or I can send it by fax.

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