Hepatitis is an often misunderstood disease. It has a long history of association with sex and drug use, and while it’s accurate these are two possible methods of infection, they are far from the only ones. The truth is, everyone is susceptible to the various strains of the virus – which is why the hepatitis A vaccine and hepatitis B vaccine are so important for our children, starting from Day 1.

What is hepatitis

Hepatitis is the name of a disease as well as the name of a type of virus. The disease, an inflammation of the liver, is most often caused by the viral infection, though more rarely, it can also be caused drug abuse, autoimmune disorders, or other infections.

It’s most commonly caused by one of five viral strains: hepatitis A, B, C, D and E.

Hepatitis A and E are typically contracted by consuming contaminated food and water or through fecal contamination, particularly in the developing world, while B, C and D are typically transmitted via bodily fluids. Infection from a family member living in close quarters to a child is one of the most common ways kids contract hepatitis.

Why you should care

Hepatitis is an even more serious disease than tuberculosis; the world’s number of yearly deaths linked to hepatitis has passed the number of yearly deaths from AIDS, TB or malaria. While the infection itself isn’t necessarily fatal, the resulting liver damage and complications can be chronic and even lead to death.

In India, only around 5% of the population has the disease – however, certain strains are easily spread and epidemics are possible. In 1988, a hepatitis A outbreak in Shanghai sickened 300,000 people.

The world has not seen many outbreaks on that scale in more recent years; while a 2009 hepatitis B outbreak in Gujurat tragically killed 49 people, it only sickened less than 200. This change is in large part thanks to the hepatitis vaccine that guard against the infection. It exists in three forms: A, B (which also provides protection against D), and E. But the hepatitis vaccine for E is not widely available yet. There is no vaccine for C.

Why babies should get hepatitis vaccines

It’s not fun to watch a newborn get pricked with a needle. The first dose of the hepatitis B vaccine is administered 24 hours after birth, and it’s a bittersweet welcome into the world. (The hepatitis A vaccine series starts at age 1.) But there are many reasons to vaccinate your child against hepatitis starting from Day 1.

The first is that many people, particularly children, infected with hepatitis don’t know it; their symptoms may not always manifest. A baby who picks up an infection from an unwitting family member may not display symptoms — but she could be set up for a lifetime of serious liver trouble.

The second is that baby daycares and day schools are frequent sites of hepatitis outbreaks. Frequent diaper changing of many babies and toddlers facilitates the spread of germs, even in centres that value good hygiene and sanitation. (This could also be true in a joint home with many young children.) Hepatitis A’s ability to live outside the body for months and hepatitis B’s ability to live on objects for a week or more also means kids don’t have to come into direct contact with the virus to pick it up.

The third is that the hepatitis B vaccine is most effective in children. Taken in its complete series of three injections, it fully protects more than 95% of infants, children and adolescents from the virus, while the vaccine fully protects 90% of adults.

Why the hepatitis B vaccine controversy is only so-called

There has been a (specious) dispute on administering the hepatitis B vaccine for babies for a few years. In 2013, several babies in China died after receiving a hepatitis B vaccine manufactured by BioKangtai. In response, the government suspended the use of that manufacturer’s vaccine. China has a long history of contamination and improper storage of vaccines, regardless of what disease children are being inoculated against.

More recently, in 2015 and 2016 respectively, there were reports of infants dying in Mexico and Myanmar after receiving, among other vaccines, a hepatitis B vaccine. In Mexico, an investigation determined the vaccines were mishandled and contaminated; in Myanmar, it was revealed that the vaccine was purchased by a non-medical professional, was improperly stored and may not have been the appropriate dosage.

Similarly, in 2013 in West Bengal, 60 children were hospitalised after being given orally the injectable hepatitis B vaccine when medical personnel mistook it for the polio vaccine, an oral medication. The non-medical professional who collected the medication had placed it in the wrong container.

It is a tragedy whenever any child, particularly an infant, sickens and worse, dies. And it feels like a betrayal when vaccines – medicine that’s meant to be life-saving — are caught up in the situation. It is natural to want a reason, so we can prevent it from ever happening to another. But in the cases above, all evidence points to the unfortunate circumstances, rather than the effects of the medication itself.

There are so many things out there that we can’t protect our children from; the tragic events above are a case in point. But we can protect our children from hepatitis A and B(+D). Well-stored, uncontaminated hepatitis vaccines for babies, that are administered properly in their full series, prevent diseases and save lives.