"Beware of Vaccine Bullies"--Malkin column

"PF Riley" wrote in message
...

On Tue, 10 Feb 2004 05:23:07 GMT, "Roger Schlafly"
wrote:

"Jeff" wrote
Yet, how often do think that:
1) A parent knows that another kid in class is Hep B+?

Very rare. There are only a handful of hep B+ kids in the USA.

Gosh, and 4 of them happen to be my patients? Wow!

Asian immigrants/adoptees?

"Jonathan Smith" wrote in message
m...
"Roger Schlafly" wrote in message
.net...
"Jonathan Smith" wrote
[quoting CDC article]
We investigated two situations involving hepatitis B virus
exposure
among children in day care. In the first a 4-year-old boy who
attended
a day care center developed acute hepatitis B; another child at
the
center, who had a history of aggressive behavior
(biting/scratching),
was subsequently found to be a hepatitis B carrier. No other
source of
infection among family and other contacts was identified and no
other
persons at the center became infected.

Possible, but not very convincing.

The question was - are there any documented cases of horizontal
transmission in children. The answer is - YES.

For heaven's sake, Jonathan, the proof/evidence in the day care case is
strictly circumstantial. Don't you find it somewhat odd that the
"documentation" doesn't show that the case patient was ever bitten or
scratched by the HBV+ "aggressive" child? Gee, you'd think *someone*
(parents, day care staff) would have made note of a blood-drawing
assault. Aren't you even curious as to why the investigation into the
source of the case patient's infection settled on the "aggressive"
child? Could it be, perhaps, that this child's carrier status came to
light only incidentally (i.e., not as a direct result of looking for the
source of the case subject's infection), and that once a person in the
case subject's sphere of contacts was known/found to be HBV+, the search
was halted and that person was presumed to be the source? I'd bet that
if a household member of the subject patient was found to be HBV+,
before knowledge that a day care-mate was also HBV+ came to light, the
search would have been halted then and there. (Shades of the OJ
defense...)

Did the boy bite or scratch
the kid who got infected? Did he draw blood? If others were
bitten or scratched, why weren't they infected? Could the family
have been concealing other contacts because it was suing the
day care center?

Look - I don't know. The data are reported in a medical journal.
Whether or not you believe it is of no consequence.

WHAT data? Based on the abstract, it appears that it's merely
*suspected* that the HBV+ ("aggressive") child was the source! We have
no idea about the scope of the investigation; was it immediately halted
upon the discovery of an HBV+ individual among the child's contacts?

In the second situation a
4-year-old boy with frequently bleeding eczematous lesions was
discovered to be a hepatitis B carrier after having attended a day
care center for 17 months. Testing of contacts at the center
revealed
no transmission to other children or staff (representing 887
person
months of exposure).

So transmission is unlikely, I guess.

Unlikely? Hey - I'm not putting any OR stats to it. It can happen
and it has happened.

Can? Sure. Has? Still no irrefutable proof, only suspicion.

Nationwide surveillance data showed that for the
period 1983 to 1987, 161 children 1 to 4 years of age were
reported
with acute hepatitis B. After children with known hepatitis B risk
factors were excluded, 25% (7 of 28) of children with known day
care
status were reported as day care attendees, a percentage
comparable to
national estimates of day care attendance by this age group.

If HBV was being transmitted in day care, then we would expect
that the set of kids with HBV would have a higher percentage of
day care attendees. Instead, these figures suggest that HBV
infection in uncorrelated with day care status.

Huh? Your statistical acumen is a legend on this NG - thanks for
reinforcing it.

Notice how small the numbers are. This was before the universal
HBV vaccination program was started, so the numbers are even
smaller now.

But it has happened - horizontal transmission, Roger, between children
on the playground. That's what JG asked and that's what I provided.

A *suspected* case, nothing more.

This is
the first reported case of hepatitis B virus transmission between
children in day care in the United States. Although it appears
that
day care transmission of hepatitis B is infrequent, further
studies
are needed to define the risk more accurately.

IOW, the risk is too small and hypothetical to measure.

IOW - it can happen, Roger. It did happen, Roger. It will happen
again.

*One* reported *possible* case. *Yawn*. That's supposed to justify
mandatory vaccination? Get real!

Want stats - here's something from a Japanaese university's American
footbaqll team:

http://www.cchi.com.hk/abs_reviews/h...bstract005.htm

The authors conclude that, "All players with acute hepatitis B
belonged to the same training group, which also included the HB(e)Ag
carrier. Our analysis suggests that horizontal transmission of HBV can
occur even in a sports team, probably due to contact with open wounds
during training."

In that same series of papers there is a case of student to teacher
transmission, intrafamilial transmission, the presence of virus in
fluids other then seminal.

Enough evidence to show that it can and does happen. The Japanese
experience is particularly enlightening.

There are dozens of articles that show horizontal transmission is a
risk and does happen. Just because you don't want to believe it
doesn't change the facts.

No one's denied that transmission between/among athletes has occurred
(I've read of suspected transmission between wrestlers). This is not
the school ("playground") transmission scenario/incidence being
questioned.

The epidemiology suggests that the relative risk is proportional to
the underlying population character of the infection - the risk is
higher in populations with higher carrier status. Isn't that
remarkable. That does not suggest that lack of endemic infection is
in and by itself protective.

Go ahead - argue the race card. I really don't care.

The point is clear - horizontal transmission can and does occur
between children and it happens even in the good neighborhoods.

You've cited *one* *suspected* case. Hardly convincing. If it's a
widespread occurrence, surely more (and better) documentation is
available.

"Jonathan Smith" wrote in message
m...
"JG" wrote in message
...
[...]

Just what goes takes place on your schools' playgrounds, PF?
Orgies?
Group piercings? Tattooing?

Biting?

A child who bites isn't ready for kindergarten.

Oh please. There are a lot of kids not ready for kidergarten and some
of them are in third grade.

So biting is common in your kid's school? Tsk. It's not around my
"impoverished little rock"! g

If you can find a verified, documented case of "recess
transmission,"
please point me to it. Certainly if an instance of "blood
swapping"
did
occur, post-exposure prophylaxis could be considered/initiated.


http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Abstract

[...article excerpt snipped...]

Close; day care isn't exactly school. ;-)

Day care is a lot like recess.

I wouldn't know; my kids were never in day care. I was under the
impression that day care attendees, for the most part (I understand some
kids go to day care centers after school, in lieu of being "latch-key"
kids), are younger, pre-kindergarten kids.

(It would be interesting to
know why the staff of the day care center in the first instance
cited
didn't control the behavior of a known-to-be-"aggressive" attendee,
though.) Nevertheless, there's no proof that the "passive" child
contracted HBV from the "aggressive" child; heck, the article
doesn't
even state whether the passive child was even bitten or scratched!
(I'd
hope a wound serious enough to break the skin--esp. a bite, which
would
have left a distinctive mark--would be noticed by his parents, at
least.
Even if not contemporaneously investigated, you'd think they'd
recall it
when questioned by doctors/health officials about possible sources
of
their kid's infection.)

The second instance cited--the fact that no one with whom an HBV+
kid
had regular contact became infected--just highlights how
(relatively)
difficult it is to transmit HBV.

You got what you asked for.

No; I'm looking for evidence of transmission (e.g., via playground
activities) among school-aged kids.

Now you want to discount it because you
think it's (relatively) difficult. With 30% or more of cases without
a reasonable chain of evidence as to the source, HBV infectivity is
hardly a well enough described for you to make such a conclusion.
Others have suggested that it seems to be difficult and likely to be
of low

Care to re-write the above (using complete, grammatical sentences)?

I grant you, it's not easy but it's far from impossible. You wanted
evidence, I gave it - here's another documented case.

Horizontal transmission of hepatitis B in a children's day-care
cent a preventable event.

McIntosh ED, Bek MD, Cardona M, Goldston K, Isaacs D, Burgess MA,
Cossart YE.

Department of Paediatrics and Child Health, University of Sydney.


Using molecular finger-printing, we provided evidence that, in a
children's day-care centre, a known hepatitis B virus (HBV) hepatitis
B e antigen (HBeAg) carrier transmitted HBV to another child (the
index case). The chronic HBV carrier had an exudative skin lesion and
a history of biting. We sought to identify other at-risk children and
prevent further transmission. Blood samples were collected and tested
serologically for HBV. Of the 90 other children, 78 (87 per cent) were
tested and none had serological evidence of HBV infection; 73 (81 per
cent) were of Caucasian background; 38 (49 per cent) had a history of
HBV immunisation with serological confirmation. Therefore, 1 (2.4 per
cent, 95 per cent confidence interval 1.0 to 12.8 per cent) of the 41
known susceptible contacts became infected. The risk of horizontal HBV
transmission in a children's day-care centre is low but not
negligible. Staff and children should be vaccinated when a child in a
day-care centre is a known HBV carrier.

Another *day care* report. Look, many toddlers bite and scratch. If
you find a case of "playground," horizontal transmission among
*school-aged* kids, please post it.

I
was particularly struck by the results from the Japanese university
football team.

Not exactly schoolchildren now, are they?

Do you know how many kids between 5 and 16 participate in organized
after school athletics?

Millions. (Pity even more don't, given the ever-increasing obesity rate
among kids.)

Have you ever observed a group of 10 year
olds on the playground?

Of course.

Do you have children?

Yes (including a daughter who was a first-team All-America athlete, in a
contact sport, while in college).

Have you ever seen a
skinned knee or a bloody lip?

Hundreds.

How about a nose bleed?

Of course.

There are
plenty of opportunities and plenty of evidence that it can and does
happen.

Not from day-to-day non-athletic interaction among schoolkids...

"JG" wrote in message ...
"Jonathan Smith" wrote in message
m...
"JG" wrote in message
...
[...]

Just what goes takes place on your schools' playgrounds, PF?
Orgies?
Group piercings? Tattooing?

Biting?

A child who bites isn't ready for kindergarten.

Oh please. There are a lot of kids not ready for kidergarten and some
of them are in third grade.

So biting is common in your kid's school? Tsk. It's not around my
"impoverished little rock"! g

You just aren't looking out from under it.


If you can find a verified, documented case of "recess
transmission,"
please point me to it. Certainly if an instance of "blood
swapping"
did
occur, post-exposure prophylaxis could be considered/initiated.


http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Abstract

[...article excerpt snipped...]

Close; day care isn't exactly school. ;-)

Day care is a lot like recess.

I wouldn't know; my kids were never in day care.

Goody for you, super mom.

I was under the
impression that day care attendees, for the most part (I understand some
kids go to day care centers after school, in lieu of being "latch-key"
kids), are younger, pre-kindergarten kids.

so all of a sudden between 4 and 6 kids grow up and stop rough
housing? Not in my school, but then again, we let kids be kids in my
high class nannyhood.

(It would be interesting to
know why the staff of the day care center in the first instance
cited
didn't control the behavior of a known-to-be-"aggressive" attendee,
though.) Nevertheless, there's no proof that the "passive" child
contracted HBV from the "aggressive" child; heck, the article
doesn't
even state whether the passive child was even bitten or scratched!
(I'd
hope a wound serious enough to break the skin--esp. a bite, which
would
have left a distinctive mark--would be noticed by his parents, at
least.
Even if not contemporaneously investigated, you'd think they'd
recall it
when questioned by doctors/health officials about possible sources
of
their kid's infection.)

The second instance cited--the fact that no one with whom an HBV+
kid
had regular contact became infected--just highlights how
(relatively)
difficult it is to transmit HBV.

You got what you asked for.

No; I'm looking for evidence of transmission (e.g., via playground
activities) among school-aged kids.

Give me a break - you asked for horizontal - you got it. Every one of
the citations referenced back that in that age group (kids before sex
and drugs) can be exposed and can become infected. The US model is a
poor one because the background prevalence is pretty low. That
doesn't change the vector or the existance albeit small of a
transmission risk. You said it doesn't happen - the literature says
it does.

Now you want to discount it because you
think it's (relatively) difficult. With 30% or more of cases without
a reasonable chain of evidence as to the source, HBV infectivity is
hardly a well enough described for you to make such a conclusion.
Others have suggested that it seems to be difficult and likely to be
of low

Care to re-write the above (using complete, grammatical sentences)?

I don't take responsibility for my newsreader hickups. I also don't
criticize others - but I can make an exception in your case.

I grant you, it's not easy but it's far from impossible. You wanted
evidence, I gave it - here's another documented case.

Horizontal transmission of hepatitis B in a children's day-care
cent a preventable event.

McIntosh ED, Bek MD, Cardona M, Goldston K, Isaacs D, Burgess MA,
Cossart YE.

Department of Paediatrics and Child Health, University of Sydney.


Using molecular finger-printing, we provided evidence that, in a
children's day-care centre, a known hepatitis B virus (HBV) hepatitis
B e antigen (HBeAg) carrier transmitted HBV to another child (the
index case). The chronic HBV carrier had an exudative skin lesion and
a history of biting. We sought to identify other at-risk children and
prevent further transmission. Blood samples were collected and tested
serologically for HBV. Of the 90 other children, 78 (87 per cent) were
tested and none had serological evidence of HBV infection; 73 (81 per
cent) were of Caucasian background; 38 (49 per cent) had a history of
HBV immunisation with serological confirmation. Therefore, 1 (2.4 per
cent, 95 per cent confidence interval 1.0 to 12.8 per cent) of the 41
known susceptible contacts became infected. The risk of horizontal HBV
transmission in a children's day-care centre is low but not
negligible. Staff and children should be vaccinated when a child in a
day-care centre is a known HBV carrier.

Another *day care* report. Look, many toddlers bite and scratch. If
you find a case of "playground," horizontal transmission among
*school-aged* kids, please post it.

What makes these kids any less susceptible? I've seen more bloody
noses, skinned knees, and exchange of spit on the playground than in
day care.

I
was particularly struck by the results from the Japanese university
football team.

Not exactly schoolchildren now, are they?

No - university students. So we bounded the upper and lower and you
argue U-shaped curve with zero probability in the formative years?

Do you know how many kids between 5 and 16 participate in organized
after school athletics?

Millions. (Pity even more don't, given the ever-increasing obesity rate
among kids.)

OK - so, somehow this isn't enough to have a non-zero risk?

Have you ever observed a group of 10 year
olds on the playground?

Of course.

Do you have children?

Yes (including a daughter who was a first-team All-America athlete, in a
contact sport, while in college).

Have you ever seen a
skinned knee or a bloody lip?

Hundreds.

How about a nose bleed?

Of course.

There are
plenty of opportunities and plenty of evidence that it can and does
happen.

Not from day-to-day non-athletic interaction among schoolkids...

Millions of student athletes?

OK - I give up. I'm not wasting my time arguing semantics and
conjecture. My time is much more valuable than that. You got what
you asked for and your denial that it isn't exactly what you meant is
much to much like a Schlafly. And more of that level crap is not
needed in this world.

js

"JG" wrote in message ...
"Jonathan Smith" wrote in message
m...
"Roger Schlafly" wrote in message
.net...
"Jonathan Smith" wrote
[quoting CDC article]
We investigated two situations involving hepatitis B virus
exposure
among children in day care. In the first a 4-year-old boy who
attended
a day care center developed acute hepatitis B; another child at
the
center, who had a history of aggressive behavior
(biting/scratching),
was subsequently found to be a hepatitis B carrier. No other
source of
infection among family and other contacts was identified and no
other
persons at the center became infected.

Possible, but not very convincing.

The question was - are there any documented cases of horizontal
transmission in children. The answer is - YES.

For heaven's sake, Jonathan, the proof/evidence in the day care case is
strictly circumstantial. Don't you find it somewhat odd that the
"documentation" doesn't show that the case patient was ever bitten or
scratched by the HBV+ "aggressive" child? Gee, you'd think *someone*
(parents, day care staff) would have made note of a blood-drawing
assault. Aren't you even curious as to why the investigation into the
source of the case patient's infection settled on the "aggressive"
child? Could it be, perhaps, that this child's carrier status came to
light only incidentally (i.e., not as a direct result of looking for the
source of the case subject's infection), and that once a person in the
case subject's sphere of contacts was known/found to be HBV+, the search
was halted and that person was presumed to be the source? I'd bet that
if a household member of the subject patient was found to be HBV+,
before knowledge that a day care-mate was also HBV+ came to light, the
search would have been halted then and there. (Shades of the OJ
defense...)

Did the boy bite or scratch
the kid who got infected? Did he draw blood? If others were
bitten or scratched, why weren't they infected? Could the family
have been concealing other contacts because it was suing the
day care center?

Look - I don't know. The data are reported in a medical journal.
Whether or not you believe it is of no consequence.

WHAT data? Based on the abstract, it appears that it's merely
*suspected* that the HBV+ ("aggressive") child was the source! We have
no idea about the scope of the investigation; was it immediately halted
upon the discovery of an HBV+ individual among the child's contacts?

In the second situation a
4-year-old boy with frequently bleeding eczematous lesions was
discovered to be a hepatitis B carrier after having attended a day
care center for 17 months. Testing of contacts at the center
revealed
no transmission to other children or staff (representing 887
person
months of exposure).

So transmission is unlikely, I guess.

Unlikely? Hey - I'm not putting any OR stats to it. It can happen
and it has happened.

Can? Sure. Has? Still no irrefutable proof, only suspicion.

Nationwide surveillance data showed that for the
period 1983 to 1987, 161 children 1 to 4 years of age were
reported
with acute hepatitis B. After children with known hepatitis B risk
factors were excluded, 25% (7 of 28) of children with known day
care
status were reported as day care attendees, a percentage
comparable to
national estimates of day care attendance by this age group.

If HBV was being transmitted in day care, then we would expect
that the set of kids with HBV would have a higher percentage of
day care attendees. Instead, these figures suggest that HBV
infection in uncorrelated with day care status.

Huh? Your statistical acumen is a legend on this NG - thanks for
reinforcing it.

Notice how small the numbers are. This was before the universal
HBV vaccination program was started, so the numbers are even
smaller now.

But it has happened - horizontal transmission, Roger, between children
on the playground. That's what JG asked and that's what I provided.

A *suspected* case, nothing more.

This is
the first reported case of hepatitis B virus transmission between
children in day care in the United States. Although it appears
that
day care transmission of hepatitis B is infrequent, further
studies
are needed to define the risk more accurately.

IOW, the risk is too small and hypothetical to measure.

IOW - it can happen, Roger. It did happen, Roger. It will happen
again.

*One* reported *possible* case. *Yawn*. That's supposed to justify
mandatory vaccination? Get real!

Want stats - here's something from a Japanaese university's American
footbaqll team:

http://www.cchi.com.hk/abs_reviews/h...bstract005.htm

The authors conclude that, "All players with acute hepatitis B
belonged to the same training group, which also included the HB(e)Ag
carrier. Our analysis suggests that horizontal transmission of HBV can
occur even in a sports team, probably due to contact with open wounds
during training."

In that same series of papers there is a case of student to teacher
transmission, intrafamilial transmission, the presence of virus in
fluids other then seminal.

Enough evidence to show that it can and does happen. The Japanese
experience is particularly enlightening.

There are dozens of articles that show horizontal transmission is a
risk and does happen. Just because you don't want to believe it
doesn't change the facts.

No one's denied that transmission between/among athletes has occurred
(I've read of suspected transmission between wrestlers). This is not
the school ("playground") transmission scenario/incidence being
questioned.

The epidemiology suggests that the relative risk is proportional to
the underlying population character of the infection - the risk is
higher in populations with higher carrier status. Isn't that
remarkable. That does not suggest that lack of endemic infection is
in and by itself protective.

Go ahead - argue the race card. I really don't care.

The point is clear - horizontal transmission can and does occur
between children and it happens even in the good neighborhoods.

You've cited *one* *suspected* case. Hardly convincing. If it's a
widespread occurrence, surely more (and better) documentation is
available.

I gave you a list of references. Horizontal child to child
transmission is possible and has occured. I really don't care if the
handful of examples are insufficient to meet your data threshhold.

You got what you asked for - or do you insist that it is impossible?

Gees - what will you think of next.

On Tue, 10 Feb 2004 16:10:10 -0700, "JG"
wrote:

"PF Riley" wrote in message
...

On Tue, 10 Feb 2004 05:23:07 GMT, "Roger Schlafly"
wrote:

"Jeff" wrote
Yet, how often do think that:
1) A parent knows that another kid in class is Hep B+?

Very rare. There are only a handful of hep B+ kids in the USA.

Gosh, and 4 of them happen to be my patients? Wow!

Asian immigrants/adoptees?

Only one of them. You and Roger seem not to understand that white
people get hepatitis B, too, you know.

PF

On Tue, 10 Feb 2004 16:10:15 -0700, "JG"
wrote:

"Jonathan Smith" wrote in message
om...
There are dozens of articles that show horizontal transmission is a
risk and does happen. Just because you don't want to believe it
doesn't change the facts.

No one's denied that transmission between/among athletes has occurred
(I've read of suspected transmission between wrestlers). This is not
the school ("playground") transmission scenario/incidence being
questioned.

So you speculate that rough-housing by elementary-school students is
so substantially different in terms of transmission risk from contact
by athletes because...?

PF

On 10 Feb 2004 20:04:16 -0800, (Jonathan
Smith) wrote:

"JG" wrote in message ...

No; I'm looking for evidence of transmission (e.g., via playground
activities) among school-aged kids.

Give me a break - you asked for horizontal - you got it. Every one of
the citations referenced back that in that age group (kids before sex
and drugs) can be exposed and can become infected. The US model is a
poor one because the background prevalence is pretty low. That
doesn't change the vector or the existance albeit small of a
transmission risk. You said it doesn't happen - the literature says
it does.

I think she got stuck arbitrarily on grade-school age when I mentioned
"recess." I am surprised that JG is engaging in Schlaflyesque
weaselling -- claiming first that horizontal transmission is not a
concern among "infants/children" and then narrowing this proclamation
to grade-school children only once evidence of horizontal transmission
among preschool-age and high school-age children is presented, in
order to continue to be "right." I agree with you on your decision to
give up on this one.

Apparently, for JG, the "best" plan to avoid hepatitis B in childhood
it:

1. Don't put your child in daycare.
2. If your child gets bitten or scratched by another child, demand to
know his or her hepatitis B status, then try to prevent infection with
post-exposure prophylaxis if necessary.
3. And, most importantly, never let your child play with Asian kids.

My plan:

1. Get the hepatitis B vaccine series.

PF

"JG" wrote in message ...
"PF Riley" wrote in message
...

On Sun, 8 Feb 2004 21:38:46 -0700, "JG" wrote:

"PF Riley" wrote in message
...

So they'll just go to the library instead the playground at recess?

If you can find a verified, documented case of "recess transmission,"
please point me to it.

Well, a possible case of "daycare transmission" is cited elsewhere on
this thread, at least.

Certainly if an instance of "blood swapping" did occur, post-exposure
prophylaxis could be considered/initiated.

Except the chronic hepatitis B carriers who attend public school that
I know keep it a secret, even from the school.

A diligent parent would undoubtedly notice a bite wound, even if the kid
didn't tell him/her about it.

Isn't that a wonderful assumption - diligent parent. You don't have
any boys, do you.

If a kid bit my kid, I'd certainly
request that the biter divulge/prove his/her HBV (and HIV, for that
matter) status. If the biter's parents refused, I'd take them to court.

Now, who are you going to sue? Which kid was it? When was it? What
would your reaction be if a parent asked YOU for your daughters
medical records to PROVE she didn't have a disease? What would your
reaction be if your daughter denied having bitten the other child?
How would you react to a lawsuit?

Bet you're just a hit in your neighborhood.

Hey, I have an idea! Instead of expecting daycare providers to protect
your child from any physical conflict with other children, ...

In the case cited, the HBV+ kid *was known* to be "aggressive."

OK - so should we exclude this child from day care? Put him in
solitary?

...and
expecting any hepatitis B carriers at school to wear a fluorescent ID
bracelet so that you can run to the school nurse for an antibody shot
should you contact his or her body fluids,

Huh? Why not just assume everyone's *not* a carrier until there's a
need to know (e.g., after a biting incident)?

Because it's silly? Because its impossible?

why not have everyone get
an easy three-dose vaccine series when they're babies and you can
relax a little about it! Or, better yet, let's use Roger's "logic:"
Have everyone get the vaccine so that no one has to!

By the way, the Malkin article is crap, because both she and her
doctor are idiots. Reading the article is like watching two retards
argue.

LOL. That's constructive criticism now, isn't it? g

I thought it was a pretty good description.


I have no problem skipping hepatitis B and polio vaccines for babies
of parents who really don't want them. (My families from India who
travel there frequently with their young infants would theoretically
be an exception, although they know better.) Most of them end up
getting those shots later, anyway. To me, however, a parent telling me
they don't want DTaP, Prevnar, or Hib is like telling me they don't
use an infant car seat. ("Oh, I'll just make sure he's not around
anyone with any baaaaad diseases!" is like saying "Oh, I'll just hold
him REAL TIGHT if we crash!")

Gee, a ped who actually discerns the epidemiological differences among
various diseases. Way to go, PF! :-D

And a mom that finally got it - HBV horizontal transmission in
children is possible and does happen.

js

(Jonathan Smith) wrote in message om...

HBV horizontal transmission in
children is possible and does happen.

Just curious. Been watching the thread. I don't dispute that
horizontal transmission in children is possible, but it does seem
quite rare. If no other risk factors are apparent, is the risk of the
disease (probability of contracting the disease multiplied by the
average *cost* of having the disease) worth the risk of vaccination
(probability of suffering an adverse reaction multiplied by the
average *cost* of the adverse reaction)? Just what 'facts' are being
used to make this determination? Isn't family history an appropriate
consideration to take into account in making that determination?