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Haemophilus influenzae type B and Hib Vaccine

Haemophilus influenzae type B and Hib Vaccine. Dr Seyed Mohsen Zahraei Center for Communicable Disease Control. Haemophilus influenzae type b Epidemiology. Reservoir Human Asymptomatic carriers Transmission Respiratory droplets Temporal pattern Peaks in Sept-Dec and

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Haemophilus influenzae type B and Hib Vaccine

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  1. Haemophilus influenzae type B and Hib Vaccine Dr Seyed Mohsen Zahraei Center for Communicable Disease Control

  2. Haemophilus influenzae type b Epidemiology • Reservoir Human Asymptomatic carriers • Transmission Respiratory droplets • Temporal pattern Peaks in Sept-Dec and March-May • Communicability Generally limited but higher in some circumstances

  3. Estimated Incidence* of Invasive Hib Disease, 1987-2000 *Rate per 100,000 children <5 years of age

  4. Hemophilus influenzae type b, 1986 Incidence by age group

  5. Haemophilus influenzae type b – United States, 1996-2000 • Incidence has fallen 99% since prevaccine era • 341 confirmed Hib cases reported during 1996-2000 (average of 68 cases per year) • Most recent cases in unvaccinated or incompletely vaccinated children

  6. Hemophilus influenzae type bRisk factors for invasive disease • Exposure factors • household crowding • large household size • day care attendance • low socioeconomic status • low parental education • school-aged siblings • Host factors • race/ethnicity • chronic disease

  7. Haemophilus influenzae type bPolysaccharide Vaccine • Available 1985-1988 • Not effective in children <18 months of age • Effectiveness in older children variable

  8. Polysaccharide Vaccines • Age-related immune response • Not consistently immunogenic in children 2 years old • No booster response • Antibody with less functional activity

  9. Polysaccharide Conjugate Vaccines • Stimulates T-dependent immunity • Enhanced antibody production, especially in young children • Repeat doses elicit booster response • Antibody is biologically active in vitro

  10. Haemophilus influenzae type b Conjugate Vaccines • Pure polysaccharide vaccines (1985-1989) not effective in infants • 3 conjugate vaccines licensed for use in infants in USA • Chemically and immunologically different

  11. Conjugate Hib Vaccines PRP-D ProHIBIT HbOC Hibtiter PRP-T ActHIB, OmniHIB, TriHIBit PRP-OMP PedvaxHIB, COMVAX

  12. Vaccine 2 mo 4 mo 6 mo 12-18 mo HbOC x x x x PRP-T x x x x PRP-OMP x x x Haemophilus influenzae type b Vaccine Routine Schedule

  13. Haemophilus influenzae type b Vaccine • Vaccination at <6 weeks of age may induce immunologic tolerance to Hib antigen • Minimum age 6 weeks • Minimum interval 4 weeks for primary series doses

  14. Haemophilus influenzae type b VaccineInterchangeability • All conjugate Hib vaccines interchangeable for primary series and booster dose • 3 dose primary series if more than one brand of vaccine used

  15. Map of countries have introduced Hib vaccineMarch 2014

  16. Haemophilus influenzae type b VaccineDelayed Vaccination Schedule • Children starting late may not need entire 3 dose series • Number of doses child requires depends on current age • All children 12-59 months of age need at least 1 dose

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