How are Haemophilus influenzae infections prevented?

Updated: Jul 02, 2019
  • Author: Joseph Adrian L Buensalido, MD; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD  more...
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Answer

The highly effective Hib conjugate vaccine, now routinely administered to infants and children, has dramatically reduced the prevalence of invasive Hib disease. [92] The vaccine elicits a protective antibody and prevents disease by reducing pharyngeal colonization with Hib.

Conversely, there is limited evidence on the effectiveness of the vaccine during pregnancy in terms of improving maternal, neonatal, and infant health outcomes. [93]

The first Hib vaccine was an unconjugated polysaccharide vaccine composed of the purified PRP capsular polysaccharide. This vaccine induced an ambiguous immune response, did not provide complete protection in children, and provided no antibody protection in infants. This led to the development of the conjugate vaccines in which PRP is covalently linked to a protein.

Currently, 3 licensed vaccines are available. They differ in the protein carrier used, the molecular size of the saccharide, and the method of conjugating the protein to the saccharide. These include HibTITER (HbOC [mutant diphtheria toxin as the carrier protein]), PedvaxHIB (PRP-OMP [major outer membrane protein of N meningitidis serogroup B as the carrier protein]), and ActHIB/OmniHIB (PRP-T [tetanus toxoid as the carrier protein]). [94]

PRP-OMP induces a good immune response after a single dose in infants, but antibody levels after 3 doses are lower than those induced by HbOC and PRP-T. The PRP-OMP vaccine is therefore recommended in American Indians and Alaska native children because of a rapid seroconversion of protective antibodies with the PRP-OMP vaccine. The vaccines are well tolerated, with occasional redness and swelling at the site of vaccination (10-15% of infants), more commonly after the initial dose than after subsequent injections. The estimated effectiveness of the vaccine in children younger than 5 years is 98%.

The combination of Hib conjugate vaccine (PRP-OMP) with hepatitis B vaccine (Recombivax HB) is licensed for use at age 2 months, 4 months, and 12-15 months. The DTaP-Hib is another combination vaccine that is licensed for use but only as a fourth dose in the DTaP and Hib series. [94]

Administer routine immunization of the Hib conjugate vaccine in all infants and children.


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