What is the role vaccination in the prevention of NTHi Haemophilus influenzae infections?

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

The currently available NTHi vaccine is PHiD CV10, marketed as Synflorix in Canada and Europe. An efficacy trial showed a protective efficacy of 52.6% against otitis media caused by the pneumococcal serotypes in the vaccine and a protective efficacy of only 35.3% against NTHi otitis. [99, 100] In children younger than 2 years, PHiD-CV10 vaccine effectiveness was 12% (95% CI; 2-22%) against all respiratory tract infections (RTI), 23% (95% CI; 0-40%) against RTI with acute otitis media, and 10% (95% CI 0-19%) against RTIs without otitis media. [101]

A phase 1, randomized, observer-blind, placebo-controlled study published in 2016 showed that NTHi vaccine formulations for adults, especially adjuvanted formulations, produced robust antibody responses in terms of humoral and cellular immune responses without any safety issues. [102]

In 2017, a systematic review of 6 placebo-controlled randomized controlled trials studied the effect of oral NTHi vaccination in preventing acute exacerbations of chronic bronchitis and COPD. The study showed a small, non–statistically significant reduction in the incidence of acute exacerbations. However, the study showed a statistically significant increase (80%) of antibiotic use in the placebo group. There was no statistically significant difference regarding hospital admission rates. [103]

The PHiD-CV was subjected to a phase 3, multicenter, open-label, controlled study involving children aged 2-7 years with asplenia and those with splenic dysfunction and was shown to be immunogenic (in terms of antibody geometric mean concentrations and opsonophagocytic activity and geometric mean titers) and well-tolerated. [104]

An investigational vaccine for NTHi and Moraxella catarrhalis is under development and is intended for use in patients with COPD who frequently suffer exacerbations related to these organisms. [105] The phase 1 study of the vaccine administered in a two-dose schedule showed an acceptable safety, reactogenicity, and immunogenicity profile.


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