|
| What's
the difference between Haemophilus influenzae type b and
influenza? |
 |
| Haemophilus influenzae type b is a polysaccharide-encapsulated
bacteria that causes a variety of invasive diseases, such as meningitis,
epiglottitis, and pneumonia. Influenza is a virus that causes the disease
influenza.
Historical note: Haemophilus
influenzae was
first isolated in 1889 from the sputum of a patient who died of influenza,
and the isolated organism (then called the Pfeiffer bacillus) was assumed
to have caused the patient's illness. Haemophilus influenzae received
its name in 1920, to acknowledge its historical association with influenza.
The viral cause of influenza
was not discovered until 1933. |
|
| If a dose of Hib vaccine was given
by mistake to a 2-week-old, should further doses of Hib vaccine
be given? |
|
| Limited data suggest that Hib vaccine
given before 6 weeks of age may induce immunologic tolerance to Hib
antigen and reduce the response to subsequent doses.
As a result, Hib vaccine should not be given earlier than 6 weeks of age. However,
if a dose was administered before 6 weeks of age, it should not be counted as
part of the Hib series. A full series of 3 or 4 doses, depending on the product
used, should be started at 2 months of age as usual. No
special protocol or testing is recommended for children who received a dose of Hib vaccine before 6 weeks of age. |
|
| I am new to a large pediatric
practice and am seeing a fair number of children who haven't received
their Hib booster. I understand there had been a recommendation to defer
boosters at one time but I was working overseas in 2008 and 2009 and
don't know what happened. Can you fill me in? |
|
| A shortage of Hib vaccine began in late
2007 when Merck voluntarily recalled certain lots of its PedvaxHIB (Hib)
and Comvax (Hib-HepB) vaccines and temporarily suspended production.
Healthcare providers were advised to conserve the limited supply of the
other Hib-containing products (e.g., sanofi's ActHIB [Hib] and Pentacel
[DTaP-Hib/IPV] vaccines) by temporarily deferring the routine Hib
booster dose in healthy children. This recommendation was in effect
until mid-2009. In July 2009, sanofi increased its production of their
two Hib-containing vaccines and in August, FDA licensed GSK's Hiberix
for use as the booster (final) dose of the vaccine series for children
ages 15 through 59 months. Thus, healthcare providers were told that
they should recall all children who were in need of the booster dose and
who had not yet reached their fifth birthday. |
|
| What is the Hib schedule for
children who have fallen behind or are completely unvaccinated? |
|
| Healthcare providers should refer to
the catch-up schedule which is approved and published each year by the
ACIP, AAP, and AAFP. Depending on the child's previous Hib vaccine
history,
this schedule will be able to establish the number of further doses
needed and the minimum intervals between doses. |
|
| Can all of the licensed Hib-containing
vaccines be used interchangeably? |
|
| Yes, with one exception. The GSK Hib
monovalent product (Hiberix) is only licensed for the booster dose. |
|
| If Hiberix is inadvertently given as
some or all of the doses of the primary series, do the doses need to be
repeated? |
|
| No. |
|
| If an infant received one dose
of Hib at 5 months, and another at 15 months, does he/she need
any more doses? |
|
| No. If a child receives a dose of Hib vaccine at 15 months of
age or older, he or she does not need any further doses regardless of
the number of doses received before 15 months of age. |
|
| Since the booster dose of
Hib vaccine can be given at 12-15 months, is it still necessary
to "boost" two months later if the first dose was given at 12-14
months? |
|
| If the child received a primary series (2 or 3 doses) of Hib
vaccine in the first year of life, then the final (booster) dose of the
series may be given as early as 12 months, provided at least 2 months
have passed since the last dose. An unvaccinated 12-14 month old child
should receive one dose as a primary series, and a booster dose 2 months
later. Unvaccinated children 15-59 months of age need only a single dose
of any licensed conjugate Hib vaccine. |
|
| A 4-year-old received dose
#3 of Hib at age 6 months. Does the child need dose #4? |
|
| Yes. All children less than 5 years old need at least one dose
of Hib vaccine on or after the first birthday. The last dose should be
separated from the previous dose by at least 2 months. |
|
| I've just evaluated a 7-year
old who does not have a record of receiving Hib vaccine. Would
a dose be indicated now? |
|
| ACIP does not recommend routine Hib vaccination of healthy children
59 months of age or older, even if they have no prior history of Hib
vaccination. |
|
| Reviewed on 1/10 |
|
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