I think in general there’s a lot to keep up with in all fields. If a doctor or practice does not see many people with a certain condition, it is more difficult to know what the current guidelines for that condition are. HBV is just one of the many things that need to be taken care of.
Please understand that this does not mean they shouldn’t know. My mother had mentioned her status to her OB/GYN in the lead up to my birth, but I was not given the birth dose (this was in 1986, it is possible that this was not routine at the time). With my brother, she was more forceful in self-advocating (possibly because she was more confident in language and society then) and he got the vaccine. He does not have Hep B, while I do.
This also is not to say to not trust your doctor and their expertise. The incorrect take from this is that your doctor knows nothing. There are times where you need to self-advocate, but also know that your doctor has a lot of knowledge. Have discussions with them with mutual respect because you’re both (hopefully) aiming for the same goal: better health for you and your family.
Regarding your other point: the recommendations say “3 to 12 months after completing the primary vaccine course (bolding mine)” This would mean you should check 3 to 12 months after the last dose of the vaccine at 6 months (i.e. at 9 - 18 months of age). By this time, they should have raised an antibody immune response.
Hi Thomas, as an FYI the first recombinant HBV vaccine was approved in 1986 (Recombivax) and universal infant vaccination wasn’t recommended until 1991. Until 1986, the first HBV vaccine called Heplisav was made from collecting blood from people who had recovered from an HBV infection (primarily gay men since they were an easily identifiable community disproportionately impacted by HBV infection). So that’s why you weren’t vaccinated at birth! Even when it was recommended that all infants be given the birth dose of the recombinant HBV vaccine in 1991, as you can imagine it took awhile for this to actually occur.
And Kim, the general rule of thumb for testing babies who are vaccinated is no earlier than 9 months. Not sure where the 3 months came from because as you noted, the 3-dose series is given at birth, 1 month and generally 6 months. Be sure to talk to your child’s pediatrician about whether it’s ok to wait to test your daughter until later, but personally, I would probably get her tested when she goes in for her next vaccination to get everything done at one visit. But I’m a nurse and tend to be very practical! Always, Joan
Basically, the serum derived vaccine was available since '83 and OK’d for use in neonates from '85, but it wasn’t until '87 when they were recommended for at risk infants (and even then it was patchy in implementation.
My brother (born in '89) was probably given the recombinant vaccine (which was approved in '87) at birth.
Thomas you had a wonderful mother! Even though she didn’t know about prophylaxis for your birth, she certainly spoke up for your younger brother. So many hep b infected moms here in the U.S. didn’t know about protecting their newborns through vaccination in the late 1980’s. Thanks for sharing your additional research … always, Joan
Hello Mr. Tavis,
My name is Andreas and I am diagnosed with hepatitis B. I really want to have kids. Is it possible for a man to have safely a child if the woman is fully vaccinated? Is there any chance of transmiting the virus to the kid or the woman? What are the necessary steps to be taken?
First of all, I am not a physician so I can only give general advice based on the biology of the virus.
I fully understand your desire to have kids. I have 2 sons (grown and out of the house now), and they are the joy of my life. I can’t wait to have grandchildren, but my sons are in no hurry to settle down.
Yes, it can be safe to have children as a man when HBV+. Your partner’s vaccination status is the most important issue because the vaccine works in 93-95% of people. I recommend testing her HBs antibody levels prior to having unprotected sex to make sure they are high enough to block the virus. Her doctor can easily do that—it is a simple blood test. If you are on therapy it will suppress the virus in your blood a very great deal, reducing chances of transmission even further. Your doctor can tell you if you fall under the treatment guidelines or not. Of course, disclose your status to your partner and make sure she agrees with the transmission control plan. Finally, be very sure to have the child vaccinated right in the delivery room. This will block transmission to the child in the very unlikely event that your partner becomes infected between now and the delivery.
Your doctor and your partner’s doctors can give you detailed information based on your individual case, and they can provide valuable medical advice. I urge you to discuss this with them as you and your partner make your decision.
Thank you very much for your prompt and elaborate response.
To be perfectly honest I am not planning at having a child at the moment. My question is rather general as I am intrested in having childern in the future. I had read that when a mother is diagnosed with HBV there are a series of measures that must be taken. It is my understanding that when the man is diagnosed with HBV as long as the woman has not tested positive, the kid and her is safe. right?
I understand that there are certain measures that must be taken (e.g. vaccination immediately after the birth) but is a father to baby transmition possible even if the woman is fully vaccinated and developed antibodies?
Hello Neptune!
Thank you for sharing. That’s very nice!
I want to have kids eventually (I am 25) and I started looking at the risks for the mother and kid. I found a lot of info about the mother having HBV but nothing about the father. As a matter of fact, the only thing I could find is that as long the mother is vaccinated (and has developed antibodies) everyone is safe and I wanted to check.
There is no risk of direct father to child transmission prior to birth if the mother does not become infected during gestation. After birth, there is a risk of transmission, but it is very, very low and would require direct blood to blood contact between the father and child (such as if they were both cut simultaneously doing something and some of the fathers’ blood got in the child’s cut while he tended to her/his wound first – a very unusual scenario). Suppressing viral titers in the father by drug treatment would even further reduce the risk. The risk drops much more if the child is vaccinated right at birth (as is recommended). So basically, this is something to be aware of and manage, but certainly not something to block you from the joy of raising a family.
If the mother has a high enough antibody titer against HBV (your doctor can tell you for sure after a simple blood test on the mother), then the child is protected from transmission at birth. Also, because some of the mother’s antibodies are transmitted across the placenta to the child, the child shares some of the mother’s immunity for a couple of months after birth!
I just found out I am pregnant and currently am on Vemlidy. My doctor isn’t sure if I should continue it during pregnancy or not. I’m hoping someone can help advise me as I’ve waited 16.5 years for this pregnancy and don’t want to risk harming the baby. My info is below.
I was diagnosed with hep B in 1990 @ 6 years old. I’ve been on antiviral treatment for the last 17 years and am currently on Vemlidy with:
undetectable viral load.
Hep BE antigen +
Hep BE antibody -
Any information you can give me is greatly appreciated!
Welcome to HepBCommunity and congratulations on your pregnancy. Regarding your question this is probably something that the @HealthExperts could provide some further information on.
It is thought that Vemlidy is very safe to continue in pregnancy.
There is not much information specifically on Vemlidy as it is a new type of tenofovir, however there is a lot of information on its active component Tenofovir in pregnancy. For patients on any form of tenofovir it is recommended that the medication is continued in pregnancy as it keeps the mum well and prevents transmission of Hep B to the baby. Breast feeding is also fine. So don’t make any changes. All the best for your pregnancy.
Congratulations on your impending baby!! That is exciting news.
It is also really important to have your infant vaccinated against HBV at birth. Most countries recommend administering the first of the 3 vaccine doses right in the delivery room. Vaccination immediately after birth has been shown to be very effective at stopping transmission to the baby. Keeping your HBV very low with tenofovir-based drug plus vaccinating the infant is a great way to protect the little one!
Yes I agree with the other specialists that you should continue on your Tenofovir during pregnancy to reduce the risk of transmitting hepatitis B to your baby. Tenofovir has been taken during pregnancy by many women worldwide and it is thought to be very safe.
All the best!
Mark Douglas (Infectious Diseases Specialist)
Thank you all for your responses. I will be staying on the Vemlidy and registering with them so they’ll have more info regarding Vemlidy and pregnancy.
Dear Christy, it’s wonderful that so many doctors responded to your question about vemlidy and your pregnancy. But I want to reinforce what Dr. John Tavis wrote about making sure that your newborn receives the first dose of the hep b vaccine in the delivery room. And if possible, 1 dose of the HBIG (hep b immune globulin). It is very important to protect your newborn immediately after birth to prevent a possible infection from the hep b virus. You only have one chance. So that’s why the Hepatitis B Foundation recommends making sure that the 1st dose of hep b vaccine and 1 dose of HBIG is available in the delivery room so your newborn receives both shots soon after birth. Making sure of this AND taking vemlidy for the entire 9 months of pregnancy to keep your viral load as low as possible will definitely eliminate the risk of possible transmission.
Good luck with the pregnancy and keep us posted on how things go. And of course we’d all love to know whether you’re having a boy or a girl?!!! Always, Joan