Risks of transmission when vaccination series not finished

Question

I'm a 36 year old female with chronic hep b. I have a very low viral load (last test was less than 20 iu/ml), I've never received treatment and all liver tests and ultrasounds have been normal so far.

I have two questions both related to transmission risk when vaccination series not completed.

  1. My son was tested (negative) at six months of age and subsequently was vaccinated in a three series scheme (0, 1 and 6 months following). What is the risk that I transmitted the virus before the vaccination series was complete, let say between first and second vaccination? I was nursing him.

  2. My 5 month old daughter received a first vaccination at birth and received the second at one month. She is due for her last one in a month. Now to my worry: I cut her nails today with a nail clipper I had used about six days ago (no visible blood when i used it) and I accidentally cut her finger so she started bleeding! What are the risks of transmission given that she hasn't finished the vaccination series? I totally forgot i had used the clippers....

I'm worried sick...

Answer

You ask very good questions and I know you are a very good mother..

First of all, there is no risk to your son related to prior breastfeeding. Check out this CDC website, which will relieve your fears. http://www.cdc.gov/breastfeeding/disease/hepatitis.htm

Secondly, the nail clipper event should not be an issue if you do not remember cutting yourself. Yes, in general we would not recommend sharing of razors and nail clippers, but the risk of HBV transmission to your daughter through the nail clipper is very low if you do not remember getting your blood on it. I think you would remmber this.

You could always get testing of your daughter in the future, but a highly doubt she would be infected. Finally, there are data to show that two doses of vaccine decrease the risk of HBV infection and certainly decrease the risk of chronic infection if transmission does occur. So I think you can call your pediatrician to discuss, but I would not worry about this any more since I believe the risk to be very low.