by Katie Porterfield
November 29, 2011

What is hepatitis B?
Hepatitis B is a serious liver disease caused by the hepatitis B virus (HBV). It is spread when a person comes into contact with blood or other body fluids from a person infected with hepatitis B. Adults can get infected by having sex or sharing needles with an infected person. Babies born to mothers with hepatitis B can be infected during childbirth.

Hepatitis B infection can be either acute (a short-term illness) or chronic (a life-long disease). The acute form is more prevalent in adults. Symptoms include loss of appetite, tiredness, diarrhea, vomiting, jaundice (yellow skin and eyes), abdominal pain, joint pain, dark urine, and clay-colored bowel movements. The majority of adults infected with hepatitis B display symptoms, while children, especially those under the age of 5, seldom show signs of the disease. In fact, according to the Centers for Disease Control and Prevention (CDC), children who become infected rarely become acutely ill. Instead, more than 90 percent of infected infants and 25–50 percent of children infected between the ages of 1 and 5 years will develop chronic illness. Chronic hepatitis B can lead to liver damage, liver cancer, and even death. There is no cure for hepatitis B infection but a vaccine can prevent the disease.

Why should I vaccinate my child?
The earliest record of a hepatitis B epidemic dates back to the late 19th century, but the actual virus wasn’t identified until the late 1960s. Dr. Baruch Blumberg, who, in 1976, won the Nobel Prize for his achievement, discovered the virus while studying antibodies in blood samples. Blumberg later developed a vaccine against the virus, and in 1982, the first hepatitis B vaccine became commercially available in the U.S. Routine vaccination of children began in 1991, and since then, rates of acute hepatitis B have declined in the U.S. by approximately 82 percent. Despite this progress, the CDC estimates that about 43,000 people became infected with hepatitis B in 2008. In addition, between 800,000 and 1.4 million people in the U.S. are living with chronic HBV infection. Approximately 3,000 deaths per year are associated with viral hepatitis.

How many doses will my child receive?
The hepatitis B vaccine is typically given as a series of three or four shots (injections).

When is the vaccine given?
According to the CDC, children should get their first dose of the vaccine at birth and should have completed the series of shots within six to 18 months of age. Babies born to mothers infected with hepatitis B are give the hepatitis B vaccine and hepatitis B immune globulin at birth. A second dose of the vaccine is given at 1–2 months of age, and a third dose at 6 months of age.

What are the possible side effects?
Side effects of the vaccine include soreness at the injection site (reported in up to one in four children) and a mild fever (reported in up to one in 15 children). Parents are advised to apply a cool, wet washcloth to the sore area and give acetaminophen or ibuprofen (as directed by the child’s health care provider) for pain and fever. If symptoms persist, parents should contact their child’s health care provider right away.

When should I call a doctor?
Though the CDC estimates that severe allergic reactions occur once in about 1.1 million doses of the hepatitis B vaccine, parents should immediately alert their child’s health care provider if the child experiences difficulty breathing, wheezing, hives, paleness, or swelling of the face, throat, tongue, lips, eyes, or feet. Such side effects would likely occur within a few minutes to a few hours of receiving the vaccination. Parents should also contact their child’s health care provider if the child has a high fever or displays unusual behavior.

Katie Porterfield is a freelance writer and former magazine editor in Nashville, Tennessee. She is mom to twin boys.