New Law Requires Hepatitis B Shots for 9th & 12th Grader

[Doc L]

New law requires hepatitis B shots

Next year's 9th- and 12th-graders are targeted in Indiana
By Jennifer L. Boen jboen@news-sentinel.com



A new state law requiring ninth- and 12th-graders to have a series of

hepatitis B vaccinations before the 2005-06 school year begins has school

officials wondering how the rule will be enforced and at least one parent

unclear about it. The new law is a quirky one: It's aimed at two specific

grades and will only be around until 2007, said Zach Cattell, legislative

director for the Indiana State Department of Health. It also is a law that

schools - by law - cannot enforce. As a subsection in state code of required

immunizations for schoolchildren, the law stipulates "a child may not be

prevented from enrolling in, attending or graduating from high school for

the sole reason that the child has not been immunized under this ."



"In all my time here, I've not ever seen an immunization requirement drawn

up like this," Cattell said.



Hepatitis B is a virus that attacks the liver. It can cause lifelong

infection and cirrhosis, or scarring, of the liver and is the cause of 80

percent of all liver cancers. Hepatitis B virus - called HBV - is spread

when blood or body fluids from an infected person enter an uninfected person

through unprotected sexual contact, sharing of drug needles, through

accidental needle sticks or blood exposure on the job, or from an infected

mother to her baby during birth.



The new vaccine requirement is aimed at ninth-graders because they were the

students who just missed falling under the umbrella of the 1999 mandatory

hepatitis B vaccination law. In other words, all children who entered

kindergarten or first grade since 1999 have been required to have the series

of three shots, which are given within a six-month period of time. The shots

are routinely given to babies these days.



The next three senior classes are being targeted to ensure they are

protected before graduation. Next year's 10th-graders will be the last class

to receive the vaccine as seniors.



In 2001, the most recent year for which data is available, an estimated

78,000 people in the United States were infected with HBV; about 5,000

people die annually from HBV-caused illness. While there are treatments,

there is no cure for hepatitis B, which is why health officials have stepped

up prevention efforts.



Fort Wayne business owner Gary Osborn, who has one son entering ninth grade

and another one entering his senior year next fall, said the letter he

received from their schools informing him of the new requirement was

upsetting. Both boys attend school in Noble County.



"The letter sounded like the shots are mandated," he said. "They need to

tell you that you don't have to get them."



Mary Hess, health specialist for Fort Wayne Community Schools, said the

district has been informing parents of the new rule in school newsletters

and will likely send parents of current eighth- and 11th-graders individual

letters.



As for the non-enforcement issue, "It worries me a little," Hess said,

noting the district would probably send letters of deficiency to the parents

of ninth- and 12th-graders who haven't received the hepatitis B series. "We

probably won't say anything about the fact we won't mandate it."



Hess said some private colleges are now requiring hepatitis B vaccinations

for incoming freshmen, although Cattell said it is not yet the case at

state-owned colleges and universities.



According to the 2003 Indiana Youth Risk Behavior Survey, 49 percent of

Indiana high school students reported having had sexual intercourse at least

once, and nearly 40 percent said they were currently sexually active.



ISDH and other states are following recommendations of the CDC's Advisory

Committee on Immunization Practices, Cattell said. "The main reason the

state health department is doing this is to make sure those kids, as they

move into the higher risk group, are vaccinated."



The virus



Unlike HIV, HBV can survive outside the body at least seven days and still

transmit infection, according to information from the U.S. Centers for

Disease Control and Prevention. Most people who become infected with

hepatitis B get rid of the virus within six months, developing only an acute

infection. But 10 percent develop a chronic, lifelong infection. However,

they might not have symptoms and become unrecognized carriers of the

disease.



According to the state, 59 cases of hepatitis B were confirmed in Indiana in

2002, down from 77 in 2001, but Margaret Joseph, spokeswoman for the

Department of Health, said the numbers reflect only acute cases.



"There's no way of knowing how many chronic hepatitis B cases there are,"

she said.



The hepatitis B vaccine is one of the most expensive required for children,

costing at private doctor's offices anywhere from $52 to nearly $90 per

shot, according to several pediatric groups contacted by The News-Sentinel.



But Kelly Zachrich, executive director of Super Shot Inc., said all children

through 18, even if they have insurance, can receive the shots for free at

any Super Shot site. Super Shot participates in the federally funded

Vaccines For Children program. Some private insurance companies cover

immunizations. The Fort Wayne-Allen County Department of Health also gives

the shots for free.



Osborn said he is still not convinced of the need and has safety concerns

about the vaccine. At one time, the vaccine contained human blood parts and

also a mercury-based compound called thimerosol, used as a preservative.



But these days all components are laboratory-made, and thimerosol is no

longer used in single-dose childhood vaccines, according to the nonprofit

National Vaccine Information Center.