Vaccination

 

Vaccination

It was 1990. I was a house officer, newly graduated from medical school. It was in a teaching hospital in the Northern Nigerian town of Zaria where I grew up. I was asked to admit a very sick 24-year-old man.

He was a used car parts salesman. He was an ethnic Ibo from Southern Nigeria, far from his family, currently working in the North. Over the last few weeks, he had become increasingly unable to hold down food and water. His complexion had become yellow, all pointing to some type of liver disease.

When I examined him, his abdomen felt like he had rocks at the area of the liver. My senior resident was with me and she said simply, this is advanced liver cancer. We cannot do anything for it. We did a further work up on him and found the he had chronic hepatitis B. He likely got this at birth from his mother. This probably caused his cancer. He died 3 days later.

Another person was a colleague and close friend of my father. He was a professor and a PhD from Northwestern University in the United States. He was diagnosed with liver cancer in 1992 and chronic hepatitis B. I remember visiting him as he lay dying in 1992 with my father and his death affected me deeply as I had known him from childhood.

It was frustrating. Mother to baby transmission of hepatitis B is the commonest way of transmitting the virus in endemic areas such as China, the far East, and West Africa. About 90% of exposed babies develop chronic infections. In America, sexual spread amongst adults is more common and only about 15% of these go on to develop chronic infections.

Hepatitis B was first described in 1967 and a vaccination against hepatitis B was first made in 1969 by Dr. Baruch Blumberg at the university of Pennsylvania. He was given a Nobel prize for this in 1976. The first commercial vaccine became available in 1981 and a synthetic vaccine approved in 1986. I remember getting a version of the vaccine as a trial when I was a medical student in Africa in 1987.

 These earlier vaccines had a mercury-based preservative called thimerosal. Some linked this preservative to autism, although research has shown there is no link. Thimerosal has been removed from all US vaccines since 2001. Universal vaccination for all babies against Hepatitis B was recommended by the CDC in 1990. This has dramatically reduced the incidence of Hepatitis B in the younger population in the United States.

However, on December 5^th, 2025, in the United States, a hand picked federal advisory committee on immunization changed the recommendation against universal vaccination of babies against hepatitis B. This was under the influence of the secretary of health who is against vaccines despite having had no medical training or experience.

 I felt very sad at this news. I still vividly remember the faces of the people I have seen die from hepatitis B induced liver cancer. The vaccine is extremely safe and could have prevented those deaths, had it been available at that time.

 It will take many years for us to see the effects of these changes amongst the population. Of course, by then it would be too late for some. I hope I never have to see that look of desperation and hopelessness that I have seen in the young people who developed liver cancer from chronic hepatitis B.

 

Hepatitis B vaccination in a child