Hepatitis B Vaccine: The Importance of the Birth Dose

babiesDid you know that Saturday kicked off National Infant Immunization Week, which is part of a worldwide observance that shines the spotlight on the importance of vaccination? Most of us think of infant immunization as a tool to protect babies from childhood illnesses like chickenpox and whooping cough. But did you know that one infant immunization protects them from cancer later in life?

Globally, hepatitis B virus (HBV) is one of the top causes of cancer. Every year, it kills more than three-quarters of a million people worldwide. An HBV infection might be defeated by the immune system, but when it’s not, it can become a chronic infection. And chronic infections can lead to serious health outcomes, including cirrhosis and liver cancer. The younger you are, the less likely you’ll be able to fight off an HBV infection — 90 percent of infants infected with HBV will develop chronic infections, and 25 percent of them will go on to die prematurely after developing liver disease. Compare that to 2 to 6 percent of infected adults who will develop chronic infections.


Because infants are so vulnerable to developing chronic infections, vaccinating them against hepatitis B at birth makes sense.


Most people think of hepatitis as a bloodborne disease, and it is spread very efficiently when IV drug users share needles, during needle-stick accidents and other occupational injuries, or by using contaminated piercing needles, tattoo equipment, or acupuncture needles. Even sharing items like razors, toothbrushes, and nail clippers can do it, as the virus can survive outside of the human body for a week. HBV can also be spread by sexual contact, including vaginal and anal sex.

Lastly, babies and children can be at risk as the virus can be transmitted from mother to infant during birth, and during early childhood when risk of chronic infection is high. A significant number of people with chronic infections acquired them during early childhood, but we don’t know exactly how they got them, as their parents and other household contacts were negative for the virus or its antibodies. Since infants and children are at the highest risk for developing chronic infections, focusing on that population for prevention is very important.

Luckily, there’s a vaccine. Continue reading

STD Awareness: Which STDs Are Vaccine Preventable?

scientistWouldn’t it be great if we could wipe sexually transmitted diseases off the face of the earth? If vaccinologists have a big “to-do” list out there, probably every single infectious disease is on it, including every STD. But some STDs have a higher priority than others, while other pathogens, unfortunately, don’t yield to our efforts quite as easily as other vaccine-preventable diseases.

Celebrate National Immunization Awareness Month by taking a look at a vaccinologist’s hypothetical “to-do” list below. While we already have a couple of STDs checked off that list, there is still more progress to be made!

check boxHuman papillomavirus: Gardasil, the most widely used HPV vaccine, introduced a new-and-improved version earlier this year. Gardasil 9 protects against seven strains of HPV that collectively cause 90 percent of cervical cancers and anal cancers, plus the two HPV strains that are jointly responsible for 90 percent of genital warts. Not only that, but vaccination against HPV will also reduce the frequency of “pre-cancers,” which are cellular abnormalities that can be treated before progressing into full-fledged cancer — meaning less time, money, and anxiety spent dealing with follow-up procedures and treatments. In fact, Australia is already seeing a huge nosedive in genital warts and pre-cancers — all thanks to their sky-high HPV vaccination rates.

check boxHepatitis A and B: Hepatitis, a disease of the liver, can be caused by several types of viruses, including hepatitis A virus and hepatitis B virus. Both can be transmitted sexually, but thanks to the vaccines, you can ask to be protected against them using a combination vaccine, meaning you’ll only have to get three shots over a six-month period rather than the five shots you’d receive if you were vaccinated for the two viruses separately. Continue reading

It’s August: A Time to Be Aware of Vaccine-Preventable Diseases

Image: Kona Gallagher

There are many simple things we can do to protect our children. Image: Kona Gallagher

August is National Immunization Awareness Month. The importance of vaccination is becoming a bigger issue every year, as 2014 has seen the highest number of measles cases reported since 2000. That is scary.

Too many people think that diseases like measles, mumps, whooping cough, and chickenpox are “normal childhood illnesses,” and that their kid’s immune system is strong enough to fight off these diseases. Too many people have forgotten what it was like before vaccines were commonplace. Too many people don’t stop to think about the long-term consequences of not vaccinating. Not just for them, but for those around them. Even for people they have never met.


When people tell me measles isn’t a big deal, I feel like I’ve been punched in the stomach.


I am one of those people you have never met.

My story starts before I was even born. My older brother was given the pertussis (whooping cough) vaccine. He was one of the small percentage of recipients that had a bad reaction. So when I was born, they skipped giving it to me. Not to worry, herd immunity would protect me — at least that’s what my doctor said.  Continue reading

Over 90 Percent of What Planned Parenthood Does, Part 6: Vaccinations

Welcome to the latest installment of “Over 90 Percent of What Planned Parenthood Does,” a series on Planned Parenthood Advocates of Arizona’s blog that highlights Planned Parenthood’s diverse array of services — the ones Jon Kyl doesn’t know about.

You know what they say: An ounce of prevention is worth a pound of cure. Public health experts agree that vaccines are one of the most important advancements in medicine, and are incredibly safe and effective in preventing infectious disease. Many infectious diseases that used to lay waste to their victims are now unknown to many of us in the developed world — polio, whooping cough, measles, and rabies struck fear in the hearts of our forebears, but most young people today barely know what they are (although low rates of vaccination can still lead to outbreaks, such as 2008’s measles outbreak in Tucson). Smallpox, once a terrifying scourge, has been wiped off the planet thanks to vaccination campaigns.


We offer vaccinations against hepatitis A and B, as well as HPV.


Vaccines work by introducing antigens to your immune system. An antigen is a substance, such as a protein on the surface of a virus, that the immune system can recognize as dangerous. It is then able to attack the pathogen and, often, create a “memory” of that pathogen so it can attack it in the event of reinfection. The antigens in vaccines are very safe, and can be derived from many sources, such as inactivated (dead) or attenuated (weakened) pathogens, or fragments of pathogens. Some vaccines, such as those protecting against human papillomavirus and hepatitis B, are made with laboratory-synthesized fragments of the surface proteins of viruses, which are sufficient to produce immune response despite being completely noninfectious.

Planned Parenthood Arizona offers vaccinations against hepatitis A, hepatitis B, and human papillomavirus (HPV). All three of these viruses can be transmitted sexually, and hepatitis B and HPV can cause cancer if the infections become chronic. The hepatitis vaccines have led to all-time lows in rates of hepatitis A and hepatitis B; the HPV vaccine is still new, but emerging evidence suggests a possible decrease in HPV rates as herd immunity grows. Vaccination doesn’t just benefit you and your partner(s) — it benefits society as a whole. Continue reading

World Hepatitis Day: The History of the Hepatitis B Vaccine

Hepatitis B particles are made of a protein shell with viral DNA inside. Image: CDC

A few hepatitis B virus particles amid an excess of surface proteins. Image: CDC

In the early 1970s, Ted Slavin, a hemophiliac, learned his blood was special. Over a lifetime of transfusions, he had slowly amassed a huge collection of antibodies, which are proteins produced by the immune system that attach to invaders, such as viruses and bacteria. When he started receiving transfusions in the 1950s, blood wasn’t screened for diseases, which meant that he’d been repeatedly exposed to some pathogens. His immune system manufactured large amounts of protective antibodies to battle these constant invaders, one of which was hepatitis B virus (HBV) — resulting in blood with extremely high concentrations of hepatitis B antibodies.


After sunshine and smoking, hepatitis B is the most common cause of cancer.


His physician relayed this discovery to Slavin — most doctors wouldn’t have bothered, and in fact might have surreptitiously sold his blood to researchers. Back then, scientists were at work on a hepatitis B vaccine, and hepatitis B antibodies were a hot commodity. Likewise, Slavin needed money — his medical condition precluded regular work, and treatments were costly. He contracted with labs and pharmaceutical companies to sell his antibodies directly, for as much as $10 per milliliter and up to 500 milliliters per order.

When someone has a chronic HBV infection, the virus has “hijacked” some of his or her cells, “tricking” them into manufacturing copies of the virus. A virus consists of an outer protein shell housing genetic information — the blueprint that cells follow when they produce virus copies. When hepatitis B viruses are manufactured in cells, an excess of surface proteins is produced — these waste products litter the bloodstream, and testing for their presence allows people to be diagnosed with HBV infections. These surface proteins are called antigens — and as luck (or evolution) would have it, the antibodies our immune systems produce can attach to viral antigens, helping us to keep pathogens at bay. Continue reading

STD Awareness: Viral Hepatitis

Hepatitis A virus particles are pictured in this electron micrograph. Image: Betty Partin, CDC

Hepatitis A virus particles are pictured in this electron micrograph. Image: Betty Partin, CDC

Hepatitis isn’t commonly thought of as a sexually transmitted disease (STD) — for most people, hepatitis conjures images of contaminated food or unsanitary restaurants. But hepatitis should be on the radar of anyone who is sexually active. There are several different viruses that cause hepatitis, and some can be sexually transmitted, including hepatitis A (HAV), hepatitis B (HBV), and, to a lesser extent, hepatitis C (HCV).

While HBV is most efficiently transmitted through blood, it can also easily hitch rides from person to person via sexual fluids. However, we covered HBV in depth last year in observance of World Hepatitis Day. As May is Hepatitis Awareness Month, we’ll turn the spotlight on HAV and HCV for this month’s installment of our STD Awareness series.

Hepatitis A (HAV)

HAV spreads through fecal-oral contact and is more widespread in parts of the world with poor sanitation. It is relatively rare in the United States, although in 2003 there was a hepatitis A outbreak outside of Pittsburgh — the largest in the United States — that was traced to improperly washed raw scallions. All told, there were 650 confirmed illnesses and four deaths. HAV is very resilient and can survive outside a host for long periods of time — other foodstuffs it can contaminate include filter-feeding shellfish, which can concentrate HAV from contaminated seawater in their tissues. When these shellfish are undercooked, they can pack quite a punch as billions of virus particles are released into the unsuspecting diner’s body.


Vaccination against hepatitis A confers lifelong immunity while sparing you from illness caused by a natural infection.


Unfortunately, no matter how well you clean your fresh produce or how long you cook shellfish, certain sexual activities can increase your risk of acquiring HAV. As with intestinal parasites, which can be present in minuscule amounts of fecal matter, so too can virus particles be present in microscopic bits of feces. Oral contact with the anus (“rimming” or anilingus) is the riskiest activity in terms of HAV transmission — oral-genital contact can also do the trick, as can manual contact between the anus and the mouth. While hepatitis A outbreaks have been reported among MSM — men who have sex with men — populations, oral-anal contact is associated with increased risk for HAV infection regardless of sexual orientation. To reduce your risk of sexual HAV transmission, use latex condoms or dental dams during oral activities. HAV can also be transmitted via blood, and hepatitis A outbreaks have been reported among IV drug users. Continue reading

STD Awareness: “Can I Get an STD from Oral Sex?”

As tools to reduce risk for STD transmission, dental dams are not to be ignored.

Editor’s Note: Other posts of interest to readers include: “Gonorrhea of the Throat,” “Oral Herpes,” “Can Oral Herpes Be Spread to Genitals?,” and “Can Oral Sex Cause Throat Cancer?

Many consider oral sex to be a safer form of sexual activity compared to vaginal or anal intercourse. For this reason, they might put less emphasis on the use of latex barriers, such as dental dams and condoms, during oral sex. Unfortunately, this idea is misguided and can lead to the transmission of preventable infections.

It is generally true that oral sex presents less of a risk for contracting sexually transmitted diseases (STDs) — but this risk is not trivial, especially when people are under the impression that they don’t need to use barrier methods during oral sex. Most sexually transmitted diseases can be passed along by oral sex, including chlamydia, gonorrhea, syphilis, hepatitis B, herpes (which can be transmitted back and forth from the mouth, as cold sores, to the genital region, as genital herpes), human papillomavirus (HPV), and HIV. Even pubic lice can be transferred from the genital region to eyelashes and eyebrows! Additionally, intestinal parasites are more likely to be transmitted via oral sex than through vaginal sex. A microscopic amount of fecal matter containing parasites can be infectious, and can be unknowingly ingested when present on genitals.


Seventy percent of adolescents who reported engaging in oral sex had never used a barrier to protect themselves from STDs during oral sex.


Some bacterial STDs, such as gonorrhea and syphilis, can do permanent damage if not treated in time. Furthermore, gonorrhea of the throat is much more difficult to treat than gonorrhea in the genital or rectal areas. And some viral STDs can’t be cured (such as herpes and HIV), while others can cause chronic infections that have been linked to cancer (such as hepatitis, which is associated with liver cancer, and HPV, which is associated with throat cancer as well as cervical cancer and anal cancer). Continue reading