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Immunizations - Haemophilus Influenzae Type B

Description

An in-depth report on the purpose of immunizations and recommended schedules.

Alternative Names

Measles; Rubella; Tetanus; Vaccinations; Whooping cough

Haemophilus Influenzae Type B:

Haemophilus influenzae (H. influenzae) type b is a bacterium, which, despite its name, is entirely different from the viruses that cause influenza (the flu). Before vaccination, H. influenzae type b (Hib) was the most common cause of childhood bacterial meningitis, killing 600 American children every year and leaving others deaf, mentally retarded, or epileptic. It is rarely troublesome for adults, although it can be dangerous for anyone with chronic lung disease and those susceptible to infections.

This is a Gram stain of spinal fluid from a person with meningitis. The rod-like organisms seen in the fluid are Haemophilus influenza, one of the most common causes of childhood meningitis (prior to the widespread use of the H. influenza vaccine). The large red-colored objects are cells in the spinal fluid. A vaccine to prevent infection by Haemophilus influenza type B is available as one of the routine childhood immunizations (Hib), typically given at 2, 4, and 12 months.

Vaccine for Haemophilus Influenzae Type B

Two equally effective inactivated bacterial vaccines (commonly called Hib vaccines) are available for H. influenzae type b. All children under 5 should be vaccinated against this bacterium. The vaccine is administered as an injection at 2 and 4 months. Depending on the vaccination preparation, a third shot in the series is administered at 6 months. A booster is required at some time between 12 and 15 months of age.

Click the icon to see an image of Hib immunization.

The Hib vaccine may benefit older people who have had their spleen removed or have illnesses that put them at risk for pneumonia, including sickle cell disease, leukemia, and HIV infection.

NOTE: In December 2007, one Hib vaccine manufacturer (Merck) had to cease production of the vaccine. Production of the Merck vaccine is not expected to resume until mid-2009. As a result, a Hib vaccine shortage currently exists. The CDC and the American Academy of Pediatrics therefore recommend that the booster dose in children 12-15 months of age be deferred, except for children at high risk for complication from Hib. These children include cancer patients, children with immune-compromising conditions (such as HIV infection), children with non-working spleen, and American Indian and Alaska Native children.

The initial 3-dose series at ages 2, 4, and 6 months is not affected by this situation, and all children should be given the series. As of the writing of this report, no increase in Hib cases was seen as a result of deferring the booster dose in healthy children.

Click the icon to see an image of sickle cells.

Side Effects of Haemophilus Influenzae Type B Vaccine

Side effects of the Hib vaccine include redness and pain at the injection site, moderate fever, and, in rare cases, weakness, nausea, and dizziness.

Resources

www.immunize.org -- Immunization Action Coalition
www.cdc.gov/vaccines/ -- The National Immunization Program
www.fda.gov/cber/vaers/vaers.htm -- Vaccine Adverse Event Reporting System
www.hrsa.gov/vaccinecompensation/ -- National Vaccine Injury Compensation Program
www.immunizationinfo.org -- The National Network for Immunization Information
www.vaccine.chop.edu -- Vaccine Education Center, Children's Hospital of Philadelphia
www.vaccinesafety.edu -- Institute for Vaccine Safety, Johns Hopkins School of Public Health
www.whathealth.com -- National Partnership for Immunization
www.immunofacts.com -- Information on vaccinations
www.vaccines.org -- The Vaccine Page

References

American Academy of Pediatrics Committee on Infectious Diseases. Prevention and control of meningococcal disease: recommendations for use of meningococcal vaccines in pediatric patients. Pediatrics. 2005 Aug;116(2):496-505.

Centers for Disease Control and Prevention. Recommended Immunization Schedule for Ages 0 - 6 Years, United States, 2009.

Centers for Disease Control and Prevention. Recommended Immunization Schedule for Ages 7 - 18 Years, United States, 2009.

Centers for Disease Control and Prevention. Recommended Immunization Schedule for Adults, United States, 2009. Available online.

Centers for Disease Control and Prevention. Revised Recommendations of the Advisory Committee on Immunization Practices to Vaccinate All Persons Aged 11 - 18 Years with Meningococcal Conjugate Vaccine. Morbidity and Mortality Weekly Report. 2007:56(31);794-795.

Centers for Disease Control and Prevention. Notice to Readers: Recommendation from the Advisory Committee on Immunization Practices (ACIP) for Use of Quadrivalent Meningococcal Conjugate Vaccine (MCV4) in Children Aged 2 - 10 Years at Increased Risk for Invasive Meningococcal Disease. Morbidity and Mortality Weekly Report. 2007;56(48);1265-1266.

Centers for Disease Control and Prevention. Prevention of influenza: Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2008. Morbidity and Mortality Weekly Report. 2008:57(No. RR-7).

Centers for Disease Control and Prevention. Update on Hib Vaccine Shortage. October 22, 2008. Available online.

Chaves SS, Gargiullo P, Zhang JX, Civen R, Guris D, Mascola L. Loss of vaccine-induced immunity to varicella over time. NEJM. March 15, 2007;356:1121-1129.

Garland SM, Hernandez-Avila M, Wheeler CM, Perez G, Harper DM, Leodolter S, et al. Quadrivalent vaccine against human papillomavirus to prevent anogenital diseases. NEJM. May 10, 2007;356:1928-1943.

GlaxoSmithKline. Boostrix Prescribing Information. December, 2008.

Grijalva CG, Nuorti JP, Arbogast PG, Martin SW, Edwards KM, Griffin MR. Decline in pneumonia admissions after routine childhood immunisation with pneumococcal conjugate vaccine in the USA: a time-series analysis. Lancet. April 7, 2007;369:1179-1186.

Poehling KA, Szilagyi PG, Crijalva CG, Martin SW, LaFleur B, Mitchel E, et al. Reduction of frequent otitis media and pressure-equalizing tube insertions in children after introduction of pneumococcal conjugate vaccine. Pediatrics. April 4, 2007;119:707-715.

US Food and Drug Administration. FDA Approves Expanded Uses for Gardasil to Include Preventing Certain Vulvar and Vaginal Cancers. September 12, 2008.

US Food and Drug Administration. FDA Approves New Vaccine to Prevent Gastroenteritis Caused by Rotavirus. April 3, 2008.

US Food and Drug Administration. Zostavax Questions and Answers. Available online. Last Accessed 3/12/2009.

World Health Organization. Immunization surveillance, assessment and monitoring -- United States of America (the) reported cases. Last Updated: December 18, 2008. Available online.

Zuckerman JN. Protective efficacy, immunotherapeutic potential, and safety of hepatitis B vaccines. J Med Virol. 2006 Feb;78(2):169-77.

Reviewed last on: 3/23/2009
Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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