Assessing the Risk of Hepatitis B Infection in Infants After Vaccination

Q: Assessing the Risk of Hepatitis B Infection in Infants After Vaccination

Hello： The chances should be very low. <br>1. <br>In fact, after receiving the second dose, more than half of the individuals should have immunity against hepatitis B; the third dose is intended to help maintain immunity for a longer duration. <br>2. <br>The primary modes of tran

Regarding the issue of hepatitis B infection in newborns?

Hello Dr.
Lin: My child is currently over six months old and has received the first, second, and third doses of the Hepatitis B vaccine at birth, one month, and six months, respectively.
Since the child's grandmother is a Hepatitis B carrier, after the child received the third dose, we visited the grandmother's house a week later.
The grandmother bathed the child, but the child had a small ulcer from the BCG vaccine on their arm.
After the bath, we noticed that the grandmother had a superficial skin wound on her hand, which was not bleeding but had some serous fluid oozing out.
Considering that the child received the third dose of the Hepatitis B vaccine only a week ago, I am unsure if the child has full protection against Hepatitis B at this time.
What is the likelihood of the child contracting Hepatitis B from the grandmother? Thank you, Dr.
Lin.

Miss Wang, 30~39 year old female. Ask Date: 2019/10/23

Dr. Lin Wufu reply Internal Medicine

Hello: The chances should be very low.
1.
In fact, after receiving the second dose, more than half of the individuals should have immunity against hepatitis B; the third dose is intended to help maintain immunity for a longer duration.
2.
The primary modes of transmission for hepatitis B are vertical transmission during pregnancy or direct contact with blood (such as through blood transfusions).
The viral load of hepatitis B in tissue fluids is theoretically minimal, and there have been no confirmed cases of infection through wounds.

Reply Date: 2019/10/23

More Info

Assessing the risk of Hepatitis B infection in infants, especially after vaccination, is a crucial concern for parents, particularly when there are potential exposure scenarios involving Hepatitis B carriers. In your case, your infant has received the complete series of Hepatitis B vaccinations, which is a significant step in providing immunity against the virus.

Hepatitis B is primarily transmitted through blood and certain body fluids. The virus can be present in high concentrations in the blood, semen, and vaginal secretions of an infected person, especially if they are e-antigen positive, indicating a high viral load. In your situation, the concern arises from the interaction between your infant and your mother-in-law, who is a Hepatitis B carrier, particularly given the presence of open wounds on both individuals.

1. Vaccination Efficacy: The Hepatitis B vaccine is highly effective, with a success rate of about 95% in producing protective antibodies in healthy individuals. After the complete vaccination series (which includes three doses), most infants will develop immunity. However, it is essential to note that it typically takes several weeks for the body to build a sufficient immune response after the final dose. In your case, since your infant received the third dose just a week ago, while the vaccine is likely providing some level of protection, it may not be at its peak efficacy yet.

2. Risk of Transmission: The risk of transmission in your described scenario is relatively low but not negligible. If your mother-in-law's wounds were not actively bleeding, and if there was no direct blood-to-blood contact, the likelihood of transmission decreases significantly. The presence of tissue fluid (exudate) can contain the virus, but the concentration is generally lower than that found in blood. Moreover, the intact skin of your infant acts as a barrier to infection. However, if there were any open wounds on your infant that came into contact with infected fluid, there could be a risk.

3. Monitoring and Testing: It is advisable to monitor your infant for any signs of Hepatitis B infection, such as jaundice, fatigue, or unusual behavior. If there are any concerns, consulting with a pediatrician or a specialist in infectious diseases for testing and further evaluation would be prudent. They may recommend a blood test to check for the presence of Hepatitis B surface antibodies and surface antigens to confirm immunity and rule out infection.

4. Preventive Measures: To minimize any potential risk in the future, it is crucial to ensure that all caregivers, especially those who are Hepatitis B carriers, practice good hygiene and avoid any contact with open wounds. Additionally, ensuring that your infant is up to date with vaccinations and considering Hepatitis B immunoglobulin (HBIG) administration in high-risk exposure scenarios can provide additional protection.

In conclusion, while the risk of Hepatitis B transmission in your described scenario is low due to the infant's vaccination status, it is essential to remain vigilant and consult healthcare professionals for personalized advice and potential testing. The combination of vaccination and careful monitoring will help ensure your infant's health and safety.

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