Dr. Jack writes:
<< A
fair number of people do not become immune with the vaccine even after
3 doses (a couple of months apart).  >>

First, thanks for the swift reply. Do you have numbers on this? I have
heard this before and am curious. The family has a 3 year old who has had
the full series on schedule and am wondering now what his risk might be
in all of this. Everyone is just assuming he is fully protected.

<< If the father was
infected as a child, and this is a exacerbation of *chronic active
hepatitis*, he is, in fact, *not* infectious.  If the mother was
hepatitis B positive during pregancy, the baby should have received
immune globulin and first immunization at birth.>>

I guess I am not familiar enough with disease to know all the right
questions to ask or to understand all the answers. Is there a difference
between being a "carrier" and having "chronic active" hepatitis? And why
would this render him noninfectious? That is so interesting! The mother
was tested negative during pregnancy, but tests positive now (about 10
months since testing). That is why baby was not even considered for
either the immune globulin or the shot at birth.

I do want to say that this mom called me with baby's test results and
after talking to baby's doctor, has been assured by him that the results
showed that she was surface antibody positive and that did mean, like you
said Dr. Jack, that she *is* immune. However, her own doctor is insisting
otherwise, that the virus could be *hiding* in her liver waiting to flare
again later in life or at anytime. I am not sure what to tell her as I
don't know the specifics of the disease well enough  to claim whether one
doctor might be more accurate than another.

Mom is continuing to nurse, with the okay from the baby's doctor, unless
she hears good reason not to.

Nicki Clark