Vaccination against disease is one of the major advances in medicine and has helped prevent disease in countless individuals. Despite the importance of vaccination, many people in our country do not get the routine vaccinations, which are available. This action places them at risk of getting sick but also places those around them at risk of becoming ill. Which vaccines am I talking about? These vaccines include but are not limited to the influenza vaccine, the Pneumovax or pneumonia vaccine and the hepatitis A and B vaccines. Why don’t Americans get these vaccines? The answer is complex but usually comes down to several simple issues. Some of the issues are the lack of awareness of need, the lack of awareness of availability and the lack of the insurance company to pay for preventive medicine. As this is the Liver Lines, I would like to say a few words about the hepatitis B vaccine.
What is the hepatitis B vaccine? This vaccine is made from a recombinant process. This means that it is free of transmission of any blood borne disease. The vaccine is given as a series of three shots over six months. It is given as an intramuscular injection in the deltoid region in adults and in thigh muscle in newborns. Injection in the buttock is associated with decreased response to the vaccine and should be avoided. The real question is “Who should get the hepatitis B vaccine?” The current recommendations are that all newborns in the United States receive the vaccine in the first year of life. Officially, only adult high risk groups are recommended to undergo vaccination. These high risk groups include men having sex with men, people with multiple sexual partners, health care workers, hemodialysis staff and patients, intravenous drug users, people in institutions for the developmentally disabled, prisoners, travelers to endemic areas such as sub-Saharan Africa or the Far East, and sexual and household contacts of hepatitis B carriers. The vaccine, despite various unsubstantiated reports, which circulate the Internet, is safe and highly effective. Because of this, I tend to be more liberal in my hepatitis B recommendations. I would make the global recommendation that all people not previously vaccinated or exposed to hepatitis B should be vaccinated. The problem is cost. Insurers do not want to pay for this. I believe that they should and must pay for this critical piece of preventive medicine. Hepatitis B is a potentially fatal disease, especially in people over 40 years of age and it is preventable with vaccination. I have seen several cases of people acquiring hepatitis B from casual sexual encounters while on vacation and I have seen acute hepatitis B in crime victims. This summer, do yourself a favor, please consider ensuring that you and your loved ones are protected against hepatitis B!! It is a disease, which is present here and now and can cause considerable illness if you are not protected.
Dr. Bernstein is the Director of Hepatology for the North Shore-Long Island Jewish Health System. You may write to Dr. Bernstein, c/o Anton Newspapers, 132 E. Second Street, Mineola, NY 11501 or email: dbernste@nshs.edu
(Disclaimer: The views and opinions represented are those of the author and meant for informative purposes only. For your specific questions, consult your physician.)
