Hepatitis B Vaccination Drive to Begin

In one of the largest vaccination efforts in local history, health officials plan to dispatch dozens of nurses to nearly 100 Ventura County schools next month to inoculate thousands of sixth-graders against the potentially deadly hepatitis B.

A new state law requires that students be immunized against the virulent blood-carried virus, or they cannot enroll in seventh grade after July 1. As a result, the free series of three injections is scheduled for February, March and June.

A similar requirement for kindergartners was enacted by the Legislature in 1997, reflecting officials’ concern about a disease that infects an estimated 200,000 U. S. residents a year, hospitalizes 11,000, and kills 5,000 to 6,000 with liver ailments.

Indeed, confirmed hepatitis B cases surged here last year, said Lin Glusac, immunization coordinator for the county’s Public Health Department. Blood tests detected the virus in 129 local cases in 1998, compared to 37 the year before. And experts say just one in every 10 new infections is detected.

Supported by the county Superintendent of Schools Office, the immunization program is expected to reach many of the 10,000 sixth-graders in 96 public schools, officials said.

“This is one of the biggest [immunization] programs we’ve ever done,” Glusac said.

Some schools have already reported that nine of every 10 sixth-graders will need the inoculations, she said.

“This is critical,” county Supt. Charles Weis said. “According to the public health experts, hepatitis B spreads easily, and this could become a public epidemic if they don’t work through this inoculation system. That’s why we’re supporting it.”

Health and school officials mailed letters Monday soliciting the participation of all local school districts with sixth-grade classes. By Thursday, nine had accepted--Conejo Valley, Moorpark, Oak Park, Pleasant Valley, Fillmore, Ocean View, Hueneme, Santa Paula elementary and the county’s special-education department.

“We expect all eligible districts to participate,” Weis said. “We need to get this done.”

Two-nurse teams will be deployed to campuses beginning Feb. 1, Glusac said. Students will be offered not only hepatitis B inoculations, but also shots to protect them against measles, mumps, rubella and tetanus.

Symptoms of hepatitis B are vomiting, mild fever, fatigue, nausea, jaundice and aching muscles. The disease can cause cirrhosis and cancer of the liver.

“These [inoculations] are one of the few things that we can do to prevent liver cancer in the long run,” Glusac said. “These are diseases that don’t have to happen. We’re trying to protect these children.”

About half of those who are infected show no symptoms for years or even decades, according to the national Centers for Disease Control and Prevention in Atlanta. And teenagers show symptoms even less often--about 20% of the time. Still, these people are carriers of the disease and can give it to others without knowing it, Glusac said.

Hepatitis B is passed through body fluids, most commonly through sexual activity, intravenous drug use and contact with blood by medical professionals, said Dr. Robert M. Levin, county public health officer.

“The more sexually active, the more promiscuous you are, the more likely you are to run into this bug,” he said. “Now we’re trying to get these teens before they become sexually active.”

In some Asian cultures, where the prevalence of hepatitis B is much higher, studies have also confirmed transmission during tattooing, said Dr. Patrick Coleman, a CDC epidemiologist.

And in ways not yet clear, children can pass the disease among one another, perhaps through rough play, Coleman said.

“Hepatitis B is extremely transmissible,” he said. “It’s much more likely to be transmitted than the AIDS virus.”

The battle against hepatitis B has spanned the nation, with 26 states adopting national immunization recommendations as law. This widespread effort has replaced previous strategies that focused on immunizing drug users and gay men, Coleman said.

“What we found was that infant immunization was a far more effective way to get the vaccine into people,” he said. “What we’re seeing now is a lot of attention to a program that’s been ongoing since 1990.”

Since 1991, babies in California have received their first hepatitis inoculations at the hospital soon after birth.

“Now we’re trying to catch up with the kids born before that time,” Glusac said.

Still, surveys of local children entering kindergarten show that 38% have not completed their three-shot hepatitis B series by the time they are school age.

Yet, according to Coleman, the rate of new hepatitis B infections is down nationwide, from 11.5 per 100,000 people in 1985 to 3.9 per 100,000 in 1997.

For information, call your local school or the county Public Health Department at (800) 781-4449.

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Immunizing Against Hepatitis B

Under a new state law that takes effect July 1, students cannot enter, advance to or repeat the seventh grade if they have not received the hepatitis B vaccine, which is given in three doses over a six-month period.

Liver disease: Hepatitis B is a disease that causes inflammation of the liver. This can cause liver cell damage, which can lead to cirrhosis and an increased risk of liver cancer. Blood tests will always show if you have been infected.

Recommended Childhood Immunization Schedule

Approved by the Advisory Committee on Immunization Practices, the American Academy of Pediatrics and the American Academy of Family Physicians.

Birth, 1 mo. 2 mos.: Dose 1

4 mos.: Dose 2

6 mos. 12 mos. 15 mos.: Dose 3

18 mos. 4-6 yrs. 11-12 yrs. 14-16 yrs.: Catch-up*

* Given to those not previously vaccinated