The most recent Advisory Committee on Immunization Practices (ACIP) recommendations for Hib vaccination were published in 2014 and are available on the CDC website at www.cdc.gov/vaccines/hcp/acip-recs/vacc-specific/hib.html. Guidance for Hib vaccination is also provided in the annual childhood immunization schedule, available at www.cdc.gov/vaccines/schedules/hcp/child-adolescent.html.
Ask the Experts: Hib (Haemophilus Influenzae Type B): Vaccine Recommendations
Three monovalent Hib vaccines are available in the United States: PedvaxHIB (PRP-OMP, Merck), ActHIB (PRP-T, Sanofi) and Hiberix (PRP-T, GSK). These vaccines are composed of Hib purified polyribosylribitol phosphate (PRP) capsular polysaccharide chemically bound (conjugated) to a protein to enhance the quality of the immune response to PRP. All three vaccines are approved for infants in a 3- or 4-dose series (depending on brand).
Two combination vaccines containing Hib are currently available in the United States: Pentacel (DTaP-IPV/Hib, Sanofi) and Vaxelis (DTaP-IPV-Hib-HepB, MSP Company). Pentacel is licensed for use in children younger than age 5 years and contains Hib conjugate, DTaP, and inactivated polio vaccines; it is approved as a 4-dose series for infants at age 2, 4, 6, and 15 through 18 months, but it is not approved for use as the DTaP/IPV booster dose recommended at age 4 to 6 years. Vaxelis (DTaP-IPV-Hib-HepB, MSP Company) is licensed for use in children younger than age 5 years and is FDA-approved and recommended by CDC as a 3-dose primary series of Hib for infants at age 2, 4, and 6 months. Vaxelis is not approved for use as a Hib booster (4th) dose. Vaxelis contains the same PRP-OMP Hib antigen as PedvaxHIB, but in a reduced amount.
The ACIP recommends routine administration of a conjugate Hib vaccine series for all infants beginning at age 2 months. Infants 2 through 6 months of age should receive a 3-dose series of ActHIB, Hiberix, Pentacel, or Vaxelis, or a 2-dose series of PedvaxHIB. The first dose can be administered as early as age 6 weeks. Hib-containing vaccine should not be given before 6 weeks of age. Doses given before 12 months of age should be separated by at least 4 weeks. A booster dose (which will be dose 3 or 4 depending on vaccine type used in primary series) of any Hib-containing vaccine is recommended at age 12 through 15 months and at least 8 weeks after the most recent Hib dose. Vaxelis is recommended only for the primary Hib series and is not recommended for use as a booster (4th) dose. A different Hib-containing vaccine licensed for a booster dose should be used.
Medically stable preterm infants should be vaccinated beginning at age 2 months according to the schedule recommended for other infants, on the basis of chronological age. Unimmunized children 60 months and older who have HIV infection should receive 1 dose of Hib vaccine.
Yes. If either ActHIB, Vaxelis, Pentacel, or Hiberix is used for a routine primary series dose, a complete routine primary series consists of three doses. Vaxelis is not recommended for use as a Hib booster (4th) dose. A different Hib-containing vaccine licensed for the booster dose should be used. If Vaxelis (DTaP-IPV-Hib-HepB, MSP Company) is inadvertently given as the booster dose, the dose does not need to be repeated with another Hib-containing vaccine, if the proper spacing of prior doses is maintained.