When to Immunize Against Hepatitis B? Tell me your opinion about the newly standard practice of immunizing children against hepatitis B even though they're not sexually active. Is it safe? What are the risks? Is this anything more than another pharmaceutical victory over common sense? Please help - my ex-husband and I are locked in a battle. People with hepatitis B may suffer from a severe, prolonged, tissue-destroying infection. This is probably the worst form of hepatitis, since it has the highest potential to become chronic, with long-term risks of cirrhosis and liver cancer. The vaccine for hepatitis B, which is a genetically engineered vaccine, appears safe and effective, although it's not cheap. Until recently it was recommended only for people who were considered at "high risk" for contracting the disease - sexually active youth and adults, intravenous drug users, and health workers (because of needle sticks). The patterns of transmission are similar to HIV, although hepatitis B is far more contagious. The federal government thought that by targeting "high-risk" populations, heptatitis B could be eradicated. Not that surprisingly, many people at high risk don't think of themselves that way; moreover, the cost has been a deterrent. About 5 percent of the US population has been vaccinated for hepatitis B. But now the medical establishment is pushing for universal immunization, with the goal of eradicating the disease. In 1991, the Centers for Disease Control and Prevention recommended routine vaccination of all infants in the United States. Proof of vaccination is now required for entry into some schools. Proponents argue that even though only a small number of infections occur in children, they account for a substantial portion of chronic cases. If all kids are immunized, goes the thinking, eventually everyone will be protected from the disease. Even so, I still think it's not clear whether it is useful to immunize children who are not going to be at high risk for hepatitis B. If you can afford it and want to give it to children, I think that's fine. I would certainly consider doing so if your child was going to travel to a part of the world where the disease was endemic, such as southern China. Or, if she were going to be living in a situation where her risks for contracting it would be elevated for any reason. As far as whether we ought to be pushing for every infant and child to be vaccinated, I don't know. Ask me again a year from now.