The Hepatitis B vaccine was approved for use by the FDA over 10 years ago. It is now routinely given to newborn children and is mandatory in 42 states. Each year, approximately 200,000 people in the USA catch Hepatitis B and about 5,000 people die from it, according to the Centers for Disease Controls (CDC).

People can contract hepatitis B by direct contact with the blood or bodily fluids of an infected person: for example, by having unprotected sex or sharing needles.

The highest risk of infection are therefore found in intravenous drug users, hemophiliacs, participating in unprotected sexual activity with many people, and people whose jobs involve contact with human blood. Babies can also catch the disease from an infected mother through childbirth. Therefore, the risk of babies catching hepatitis B is very slight in comparison with the high risks categories mentioned.

However, there is now considerable debate about the importance and the safety of this vaccine. In a statement released on July 8, the Association of American Physicians and Surgeons (AAPS), representing more than 4,000 doctors, recommended an immediate moratorium on mandatory hepatitis B vaccine for children pending further research about possible side-effects. They question the mandatory requirement for a vaccine that has questionable safety.

In 1998, according to a New York Times article, the French government suspended hepatitis B vaccinations in schoolchildren, citing fears that the vaccine was causing multiple sclerosis and other neurological disorders. More recently, the National Vaccine Information Center (NVIC), a parent group based in Washington, stated that between July 1, 1990 and October 31, 1998, in the USA, a total of 24,775 adverse events, including 439 deaths, allegedly linked to the vaccine were reported to the federal drug agency. However, a spokesperson for the FDA downplayed these findings, stating that there could be many other reasons for the reported affects.

The issue recently became important in New Jersey as the State Assembly was looking to implement mandatory vaccination. Even though it was left off the legislative agenda, the Health Department began writing a rule requiring the vaccination-without allowing parents the option of refusing inoculation for their children. One state senator in New Jersey stated that "they are trying to treat the wrong people with this vaccine. They can't reach the adults through education, so this is their solution. I think it is a poor one."

In June 1999, Dr Jane Orient, Executive Director of AAPS, testified before Congress and called for an immediate halt to the vaccine. "It is apparent that critical medical decisions for an entire generation of American children are being made in small committees whose members have incestuous ties with agencies that stand to gain power, or manufacturers that stand to gain enormous profits from the policy that is made."

"Children younger than 14 are three times more likely to die or suffer adverse reactions after receiving hepatitis B vaccine than to catch the disease."

As this debate continues, more objective evidence may come to light about the rationale for the vaccine and the risks involved.