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From: To: Subject: Date: Attachments: Jerri Johnson *OAH_RuleComments.OAH Immunization Rules docket 0900-30570 Monday, July 15, 2013 4:18:24 PM Hep B and perinatal inf.docx Document on hepatitis B Jerri Johnson Public Relations Coordinator National Health Freedom Coalition' 651 688 6515 [email protected] Vaccinating all Minnesota babies for hepatitis B is not needed because most of the childhood population is not at risk for the disease Minnesota has currently only 27 cases of chronic hepatitis B infection in children ages 0 - 4. (Chronic infection means that infection has been existant for 6 months, perhaps detected by blood samples, whether or not the person got ill. ) Of those 27 cases, at least 15, and maybe more, are from perinatal infection (contracted from their mother in childbirth). These children were treated and vaccinated but developed the infection anyway. This proposed rule would not have prevented these 15 cases. The remaining 12 cases, over 4 years, amount to an average of 3 cases per year of unknown origin that might be prevented by vaccinating all babies. In a birth cohort of 70,000 babies born each year, vaccinating 70,000 babies to prevent 3 cases is equivalent to vaccinating 23,000 babies to prevent each case. If the vaccination were completely safe, one could justify this ethically. But when the vaccine has such a track record of severe adverse effects, this is not justifiable. The MN Department of Health has a very effective program to detect hepatitis B infections in newborns: All pregnant women are tested for hep B and if positive, their infants are offered hepatitis B vaccination and immunological treatment. In a typical year like 2011, 357 women were identified as positive, their babies were tested and treated, and only 1 developed hepatitis B. It was a great risk/benefit ratio to offer vaccination to these families because these infants were seriously at risk for disease. As a result, up to 357 babies at risk for the disease were protected. But for the other 69,543 babies born in 2011, born to mothers who were not infected, who were at nearly zero risk of disease, vaccinating them only puts them at risk for vaccine injury. For the state to make such a requirement, which is neither needed nor reasonable, is unthinkable. Epidemiology of hepatitis B The majority of cases of hepatitis B are found in communities of immigrants who have come here from countries where the disease is endemic. In Minnesota, the incidence of hepatitis B in native-born people is nearly zero. A study done by the Mayo Clinic of Olmstead County, for example, found that: There were 191 residents with chronic HBV infection in the community, consisting of 53% Asian, 29% African, 13% Caucasian, and 5% other or unknown race. The overall age- and sexadjusted prevalence of HBV in this community was 0.15% in 2000. The race-specific prevalence was highest among Asians (2.1%), followed by African Americans (1.9%). The prevalence among Caucasians was 0.02%. Overall, 86% were born outside the U.S., 98% of whom were non-Caucasian. In conclusion, in this Midwestern community, chronic HBV infection was predominantly seen in immigrants from endemic parts of the world. (HEPATOLOGY 2004;39;811–816.) Further MDH epidemiology reveals that 85% of hepatitis B cases are in the seven-county metro area. Persons Living with HBV in MN by Current Residence, 2011 MDH persists in attempting to require hepatitis B vaccination for infants in small-town and rural Minnesota, areas with no immigrant population, and infants of mothers known to be negative for hepatitis B. For the state to make this unreasonable requirement could only mean tragedy for those healthy infants who may be unnecessarily harmed by the vaccine.