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Hep B (hepatitis B)

The vaccine: Hep B vaccine - brand names Engerix B, Fendrix, HBvaxPro 05, HBvaxPro 10 and HBvaxPro 40.

The claim: "The hepatitis B vaccination is available on the NHS for anyone who is at increased risk of or its complications." [1]

Why is it offered to students?

It is not offered to all students, however, it is mandated for many students on health-related courses such as nursing. [2] The reasoning for this is that health workers may come into contact with contaminated bodily fluids.

The facts:

Although student nurses are considered at higher risk to the general populace, in fact the risk to nursing and other healthcare students of contracting hepatitis B is still very low.
Nurses are at a higher risk of coming into contact with bodily fluids than the general populace, but that is not the way the disease is usually spread. According to CDC Prevention Guidelines: A Guide to Action (1997), the sources of hepatitis B infection for most cases include:


Intravenous drug use (28%);

Heterosexual contact with infected persons or multiple partners (22%);

Homosexual activity (9%). [3]


Furthermore, hepatitis B is not a killer disease for most. Symptoms of hepatitis B disease include nausea, vomiting, fatigue, low grade fever, pain and swelling in joints, which can last for three to four weeks. According to Harrison's Principles of Internal Medicine (1994), in cases of acute hepatitis B "most patients do not require hospital care" and "95 percent of patients have a favorable course and recover completely" with the case-fatality ratio being "very low (approximately 0.1 percent)." [3]


What the numbers say:


Hepatitis B is not a common disease in first-world countries like the UK. Western Europe and the USA have always had among the lowest rates of hepatitis B disease in the world - 0.1% to 0.5% of the general population. [3]


The risks and side effects of the vaccine:


The US database VAERS (Vaccine Adverse Events Reporting System) shows there were 36,788 officially reported adverse reactions to hepatitis B vaccines between 1992 and 2005. Of these, 14,800 were serious enough to cause hospitalization, life-threatening health events or permanent disabilities. [4]


A 1998 study examined the link between the hepatitis B vaccine and rheumatic disorders, finding "[h]epatitis B vaccine might be followed by various rheumatic conditions and might trigger the onset of underlying inflammatory or autoimmune rheumatic diseases." [5]


In 1999, research scientist and medical graduate student professor Dr. Bonnie Dunbar, who had worked in the areas of autoimmunity and vaccine development for over twenty-five years, wrote to the Texas Department of Health regarding the health dangers of the hepatitis B vaccine. Dr. Dunbar stated:


"About five years ago, I had two individuals working in my laboratory who were required to take the Hepatitis B vaccine. Both of these individuals developed severe and apparently permanent adverse reactions as a result of this vaccine. Both of these individuals were completely healthy and very athletic before this vaccine and have now suffered severe, debilitating autoimmune side effects from this vaccine. I know the complete medical history of one, Dr. Bohn Dunbar, who is my brother who developed serious rashes, joint pain, chronic fatigue, multiple sclerosis-like symptoms, and now, has been affirmatively diagnosed with POTS (an autoimmune cardiovascular neurological problem) and finally with chronic inflammatory demyelinating polyneuropathy. His problems have been attributed to the Hepatitis B vaccine by over a dozen different specialists around the United States of unquestionable medical expertise." [6]


Vaccine ingredients:


Each 1 mL adult dose of Engerix-B contains:


20 µg of hepatitis B surface antigen adsorbed onto 0.5 mg of aluminum hydroxide;

Aluminum hydroxide;

2-phenoxyethanol;

Trace amount of thimerosal in the multi-dose vial. [7]


Can I reduce my risk of hepatitis B without getting the vaccine?


Yes. According to the Mayo Clinic, you can reduce your risk of hepatitis B through the following measures:


  • Know the HBV (hepatitis B) status of any sexual partner. Don't engage in unprotected sex unless you're absolutely certain your partner isn't infected with HBV or any other sexually transmitted infection.
  • Use a new latex or polyurethane condom every time you have sex if you don't know the health status of your partner.
  • Stop using illicit drugs. If you use illicit drugs, get help to stop. If you can't stop, use a sterile needle each time you inject illicit drugs. Never share needles.
  • Be cautious about body piercing and tattooing. If you get a piercing or tattoo, look for a reputable shop. Ask about how the equipment is cleaned. Make sure the employees use sterile needles. If you can't get answers, look for another shop. [8]


STRIVE opinion - is it worth getting this vaccine?


For the average healthy student, we would say no. However, if you are committed to studying a health-related course such as nursing, it may be difficult or impossible for you to proceed without taking the vaccine. Many people take this vaccine with no apparent adverse reactions, and statistically you are likely to be one of them. However, if you have ever reacted badly to a vaccine before, have a history of adverse reactions to vaccines in your family, or have any kind of ongoing health problem, we would advise extreme caution. Pursuing a particular career may not be worth gambling with your health for, when there are many other courses of study and career paths that do not require this vaccine. As with all vaccines, we advise you do as much research as possible, read the package insert (linked below), and talk to your healthcare provider before reaching a decision


CLICK HERE FOR FULL 16-PAGE ENGERIX-B PACKAGE INSERT (What's a package insert?)


References:

1. http://www.nhs.uk/conditions/vaccinations/pages/hepatitis-b-vaccine.aspx
2. http://www.city.ac.uk/health/courses/selection-process/occupational-health-checks
3. http://www.nvic.org/nvic-archives/newsletter/untoldstory.aspx

6. http://www.vaclib.org/email/hepbdang.htm

7. http://www.uniprix.com/en/drug-lexicon/1191/engerix-b

8. http://www.mayoclinic.org/diseases-conditions/hepatitis-b/basics/prevention/con-20022210


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