PedvaxHib (Merck) is the Haemophilus influenzae type b (Hib) vaccine preferred for American Indian and Alaskan Native (AI/AN) infants. Since Vaxelis (DTaP-IPV-Hib-HepB) contains the same kind of Hib vaccine, is it also preferred?

Yes. Both Vaxelis and PedvaxHib are preferred for Hib immunization of AI/AN infants. Historically, AI/AN infants were more likely than other U.S.-born infants to develop Hib meningitis before being old enough to complete a primary series of Hib-containing vaccine. ACIP prefers that AI/AN infants be vaccinated with PedvaxHib or Vaxelis because their Hib component (PRP-OMP) can stimulate protective levels of antibodies after the first dose.

At the time ACIP approved Vaxelis, no data were available on the immune response to the Hib component of Vaxelis after the first dose, so ACIP did not make a preferential recommendation for Vaxelis in AI/AN infants. Once the data were available, ACIP updated its recommendation, which was published in MMWR September 12, 2024: www.cdc.gov/mmwr/volumes/73/wr/pdfs/mm7336a4-H.pdf.