Natural and vaccine-induced immunity against Haemophilus influenzae type b in patients with beta-thalassemia

Natural and vaccine-induced immunity and immunological memory to Haemophilus influenzae type b (Hib) were evaluated in adolescents and adults with beta-thalassemia. At baseline 10/23 (43%) unvaccinated patients had naturally acquired anticapsular antibodies >0.15 microg/ml, the threshold of protection, compared to 9/10 (90%) aged-matched controls. Hib-conjugate vaccine (PRP-T) induced protective immune responses in all subjects and there were no differences in geometric mean concentrations at 1 month (GMC) between patients and controls (69.04 versus 40.5, respectively). Vaccine-induced immunological memory was assessed in 12 subjects with beta-thalassemia who had been vaccinated against Hib in the past. All subjects had retained PRP>1 microg/ml at baseline; PRP-T revaccination induced anamnestic responses which were similar, in terms of post vaccination antibody concentration (P=0.54) and avidity (P=0.08), with primary responses given by previously unvaccinated patients. A single dose of PRP-T induces adequate and long-lasting immunity and should be given in all unvaccinated adolescents and adults with beta-thalassemia.