by Darren Main • Summer 2001
Darren, I like your articles on gay.com, as I am a strong believer in holistic health. I exercise regularly, including doing yoga, I am trying acupuncture, and I go to a naturopathic doctor (who is not gay). I did go for full medical recently (at an allopathic doctor), and came back with excellent results. However, I tested negative for Hepatitis B and have not been vaccinated, and the doctor recommended that I consider Hepatitis B vaccine (he, like me, is a gay man). My Naturopathic doctor (who is not gay) said he normally would discourage having this vaccine, though it depends on my circumstances. (I am sexually active, though pretty selective.) What are your suggestions?
Thanks for writing, and thanks for reading my column. Your question is a very good one, but there are no easy answers. As with any medical or health decisions, it all comes down to personal choice. Understanding Hepatitis B (HBV) and the pros and cons of the vaccine might help you to make a more informed choice however.
HBV is a virus that attacks the liver. Sometimes exposure to this virus is no big deal, and you would never know you had it. If you get a mild exposure to HBV your body will build up its own immunity to the virus and there would be no need to give you a vaccine for it. According to your doctor, you have not yet been exposed, as your labs showed that you were not producing the antibodies. That is why he is recommending you get vaccinated.
Not all cases of Hepatitis B are mild, however. Oftentimes exposure to Hepatitis B can cause severe damage to your liver and make you very ill. Some of the things Hepatitis B can do include scarring the liver, liver cancer or liver failure, and even death. Because of the potential problems associated with Hepatitis B, the choice to vaccinate should be carefully considered.
The official guidelines for Hepatitis B vaccination put out by the CDC and other government agencies suggest that all people under the age of 18 receive the Hepatitis B vaccine, as well as heterosexuals who have more than one sexual partner in a six month period and men who have sex with men. The vaccine is given in three injections spread out over a six-month period. Your doctor will put you on an appropriate schedule.
If you choose not to receive the vaccination, or until you receive all three of the inoculations, it is doubly important to practice safe sex. In addition to the usual safe sex precautions that are in place for HIV and other STDs, rimming (oral/anal contact) is particularly discouraged, as this is one of the primary ways the virus is transmitted during sex.
While the CDC and other government health agencies claim that there is no risk involved with receiving the Hepatitis B vaccine, there are a growing number of people who disagree. Neil Z. Miller, author of Vaccines, Are They really Safe and Effective, said that the number one complaint his organization receives with regard to vaccine side effects is from the Hepatitis B vaccine.
According to Miller, the vaccine is so dangerous that the French government removed it from its list of suggested childhood vaccines because it was linked to Multiple Sclerosis and other neurological disorders. He also stated that the United States Congress recently held a hearing to see if there was a link between the HBV vaccine and Multiple Sclerosis.
The CDC website had this to say, “Although scientific evidence to date does not support hepatitis B vaccination causing multiple sclerosis (MS) or other demyelinating diseases a study is currently being organized in the Vaccine Safety Datalink project at CDC because of public concern about this issue in France and elsewhere . . .It will probably be at least one year, however, before any results are available.”
So this leaves each of us with a personal decision. As a gay man, you are at a higher risk for contracting HBV than others. You should also take into account your HIV status, as a bout of Hepatitis B will no doubt hit your immune system quite hard. With this in mind, you need to decide whether the risks associated with vaccination outweigh its benefits. While the vast majority of gay and bisexual men in the United States choose to receive this vaccine, it is a personal decision that you need to make for yourself.
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