Note to presenters:

Images of vaccine-preventable diseases are available from the Immunization Action Coalition website at http://www.vaccineinformation.org/photos/index.asp

Cellulitis6%

Arthritis8% Bacteremia

2%

Meningitis50%

Epiglottitis17%

Pneumonia15%

Osteomyelitis2%

Haemophilus influenzae type bClinical Features*

*prevaccination era

Incidence* of Invasive Hib Disease, 1980-2009

0

5

10

15

20

25

30

1980 1984 1988 1992 1996 2000 2004 2008

Rat

e/10

0,00

0 ch

ildre

n <

5 yr

s

*Rate per 100,000 children <5 years of age

Haemophilus influenzae type b Epidemiology

• Reservoir Human Asymptomatic carriers

• Transmission Respiratory droplets

• Temporal pattern Peaks in Sept-Dec and March-May

• Communicability Generally limited buthigher in somecircumstances

Haemophilus influenzae type b—United States, 2002-2006

• Incidence has fallen more than 99% since prevaccine era

• 123 confirmed Hib cases reported (average of 25 cases per year)

• Most recent cases in unvaccinated or incompletely vaccinated children

Haemophilus influenzae type b Conjugate Vaccines

• Two conjugate vaccines licensed for use in infants as young as 6 weeks of age

• Use different carrier proteins

• 3 doses of any combination confers protection

PRP-T ActHIB, TriHIBit

PRP-T Hiberix

PRP-OMP PedvaxHIB, Comvax

Conjugate Hib Vaccines*

*HbOC (HibTiter) no longer available in the United States

Haemophilus influenzae type b Vaccine Interchangeability

• Both conjugate Hib vaccines (except TriHIBit) are interchangeable for primary series and booster dose

• 3 dose primary series if more than one brand of vaccine used

Hiberix (PRP-T)

• Approved for children 12 months of age and older

• Approved only for the last dose of the Hib series

Haemophilus influenzae type b VaccineVaccination Following Invasive Disease

• Children younger than 24 months may not develop protective antibody after invasive disease

• Vaccinate during convalescence

• Complete series for age

Haemophilus influenzae type b VaccineUse in Older Children and Adults

• Generally not recommended for persons older than 59 months of age• Consider for high-risk persons:

asplenia, immunodeficiency, HIV infection–One pediatric dose of any conjugate

vaccine• 3 doses recommended for all persons

who have received a hematopoietic stem cell transplant

• Swelling, redness, or pain in 5%-30% of recipients

• Systemic reactions infrequent

• Serious adverse reactions rare

Haemophilus influenzae type b Vaccine Adverse Reactions

Haemophilus influenzae type b Vaccine

Contraindications and Precautions

• Severe allergic reaction to vaccine component or following a prior dose

• Moderate or severe acute illness

• Age less than 6 weeks