We strongly recommend the hepatitis B vaccine for teenagers. Even though we hope our children will not become sexually active or use IV drugs, the fact is that some teenagers and young adults do experiment with risky behaviors. And even if your child doesn’t, his or her first sexual partner might have experimented in the past. Thus, they will be at risk. If we are able to vaccinate all teenagers over a twenty year period, we will greatly decrease the transmission of this disease because the teens and twenties are the era of highest risk.
However, the public health argument is to vaccinate all infants. This is based on several lines of thought. First, it is difficult to get teenagers in the doctor’s office for vaccines. Infants are clearly a captive population, and the general idea is to give the vaccines when you have someone in your office.
Second, even though all women are tested during pregnancy to see if they are a hepatitis B carrier, sometimes mistakes happen. The wrong test might be ordered, or the wrong result might be written down. Or possibly one of the parents has an affair and contracts hepatitis B during the mother’s pregnancy, after the carrier test was done. Thus, it is possible for a mother to be a hepatitis B carrier without knowing it. Public health officials believe it is better to immunize all children at birth in order to avoid missing the one child who particularly needs the vaccine.
Finally, some children do contract hepatitis B from accidental contact with an infected person’s blood. These instances are rare but have occurred. The vaccine would protect against these accidents.
Our attitude is that the vaccine is a good idea for both the public health and the individual protection of your child. However, it is not a critical vaccine for infants, as they are unlikely to be exposed in the first several years of life. So if we have parents who are hesitant about vaccines, it is not at the top of our list, and we am comfortable putting it off until age eleven.
Having said that, the hepatitis B vaccine is now required for admission to many schools and day cares. Thus, you might need to give it earlier than you were hoping. In addition, hepatitis B is now part of many common combination vaccines, which means fewer injections for your child if you follow the recommended vaccine schedule. For these reasons, many parents just go with the path of least resistance and give the vaccine to their infants.