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Rational use of Haemophilus influenzae type b vaccine
Harry Campbell1, Harden Carter2
1Fife Health Board, Glenrothes House, North Street, Glenrothes, Fife KY7 5PB, Scotland.
Insights
Protein conjugate vaccines against Haemophilus influenzae type b (Hib) are immunogenic, effective, and safe for young children. Routine Hib immunization has significantly reduced Hib meningitis cases in infants.
Area of Science:
- Pediatrics
- Immunology
- Infectious Diseases
Background:
- Haemophilus influenzae type b (Hib) is a leading cause of bacterial meningitis in children under five.
- Early Hib vaccines using purified polyribosylribitol phosphate (PRP) showed poor immunogenicity in infants.
- Serum antibodies to the Hib PRP capsule are protective against infection.
Purpose of the Study:
- To evaluate the immunogenicity, efficacy, and safety of second-generation protein conjugate Hib vaccines.
- To assess the impact of routine Hib infant immunization on disease incidence.
Main Methods:
- Administration of second-generation protein conjugate Hib vaccines to infants.
- Monitoring of vaccine immunogenicity, efficacy, and adverse reactions.
- Analysis of Hib meningitis incidence before and after routine immunization implementation.
Main Results:
- Second-generation protein conjugate Hib vaccines demonstrated good immunogenicity and safety in young children.
- No serious adverse reactions were reported following Hib vaccination.
- Routine infant immunization with Hib conjugate vaccines led to a significant decrease in Hib meningitis.
Conclusions:
- Protein conjugate Hib vaccines are a safe and effective tool for preventing Hib disease in early childhood.
- Routine infant immunization programs are crucial for controlling Hib meningitis.
- Hib conjugate vaccines can be co-administered with other routine childhood vaccines like DPT.
Abstract:
Haemophilus influenzae type b (Hib) is a major cause of serious bacterial infection in early childhood. In many developed countries it is the commonest cause of bacterial meningitis in children under 5 years of age. Serum antibodies to the polyribosylribitol phosphate (PRP) capsule, the main virulence factor of Hib, are protective, but the early vaccines containing purified PRP were poorly immunogenic in young children. However, 'second generation' protein conjugate vaccines have been shown to be immunogenic, effective and safe in young children. No serious adverse reactions to Hib vaccine have been reported to date. Clinically, the vaccine is indicated in the first few months of life and can be given at the same time as a primary course of diphtheria, pertussis and tetanus (DPT) immunisation. The vaccine should be given by deep subcutaneous or intramuscular injection. The only specific contraindication is a history of severe local reaction or a general reaction to previous Hib vaccination. Routine immunisation of infants under 6 months of age against Hib has become part of the regular primary schedule in many countries. In Finland this has resulted in a dramatic decline in Hib meningitis.