Note:
The following two questions and answers apply to the interim period of
Hib vaccine shortage (December 2007 through late 2008):
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Please discuss the Hib vaccine recall. |
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On December 13, 2007, Merck & Co., Inc. announced a voluntary recall
of certain lots of two Haemophilus influenzae type b (Hib) conjugate
vaccines, PedvaxHIB® (monovalent Hib vaccine) and Comvax® (Hib/hepatitis
B vaccine). Merck has suspended production of its Hib conjugate
vaccines and does not expect to resume distribution of them until the
fourth quarter of 2008. Two other Hib conjugate vaccines, manufactured by sanofi pasteur and unaffected by the recall, are currently licensed
and available for use in the United States. They are ActHIB® (monovalent
Hib vaccine) and TriHIBit® (diphtheria and tetanus toxoids and
acellular pertussis [DTaP]/Hib vaccine). However, sanofi pasteur
likely will not be able to immediately provide adequate Hib vaccine to
fully vaccinate all children for whom the vaccine is recommended. |
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| What are the
recommendations for vaccination with Hib vaccine since the Merck
products (PedvaxHIB and Comvax) have been voluntarily recalled? |
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CDC recommends that
during this time of Hib vaccine shortage, providers should
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Until further notice, and only for healthy children, defer
the booster dose of Hib vaccine, which is usually given to
children at age 12-15 months. |
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Give age-appropriate doses (doses #1, #2, and #3) to
children who have not completed a primary series and need
to catch up. |
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Continue to vaccinate children at highest risk of Hib
disease according to the routinely recommended schedule,
including the booster dose. Children at highest risk
include those with asplenia, sickle cell disease, HIV
infection, immunodeficiency syndromes, and malignant
neoplasm. |
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Complete the Hib series with ActHIB or TriHIBit for
children age 12-15 months who started the series with
PedvaxHIB or Comvax and are at highest risk for Hib
disease. |
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Continue to vaccinate American Indian/Alaska Native
(AI/AN) children according to the routinely recommended
schedule. AI/AN children, particularly those younger than
age 6 months, are at highest risk of Hib disease. |
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| What's
the difference between Haemophilus influenzae type b and
influenza? |
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| Haemophilus influenzae type b is a polysaccharide-encapsulated
bacteria that causes a variety of invasive diseases,such as meningitis,
epiglottitis, and pneumonia. Influenza is a virus that causes the disease
influenza.
Historical note: Haemophilus
influenzae was
first isolated in 1889 from the sputum of a patient who died of influenza,
and the isolated organism (then called the Pfeiffer bacillus) was assumed
to have caused the patient's illness. Haemophilus influenzae received
its name in 1920, to acknowledge its historical association with influenza.
The viral cause of influenza
was not discovered until 1933. |
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| If a dose of Hib vaccine was given
by mistake to a 2-week-old, should further doses of Hib vaccine
be given? |
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| Limited data suggest that Hib vaccine
given before 6 weeks of age may induce immunologic tolerance to Hib
antigen and reduce the response to subsequent doses.
As a result, Hib vaccine should not be given earlier than 6 weeks of age. However,
if a dose was administered before 6 weeks of age, it should not be counted as
part of the Hib series. A full series of 4 doses (Hibtiter, and ActHib) or 3
doses (PedvaxHib and Comvax) should be started at 2 months of age as usual. No
special protocol or testing is recommended for children who received a dose of
Hib vaccine before 6 weeks of age. |
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| What is the Hib schedule for
children ages 15 months or older who have fallen behind or are
completely unvaccinated? |
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| Children 15-59 months of age who have an incomplete Hib vaccination
schedule, including those who are unvaccinated, should receive a single
dose of any Hib conjugate vaccine. Hib vaccine is not routinely recommended
for persons 5 years of age or older. |
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| If an infant received one dose
of Hib at 5 months, and another at 15 months, does he/she need
any more doses? |
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| No. If a child receives a dose of Hib vaccine at 15 months of
age or older, he or she does not need any further doses regardless of
the number of doses received before 15 months of age. |
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Since the booster dose of
Hib vaccine can be given at 12-15 months, is it still necessary
to "boost" two months later if the first dose was given at 12-14
months? |
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| If the child received a primary series (2 or 3 doses) of Hib
vaccine in the first year of life, then the final (booster) dose of the
series may be given as early as 12 months, provided at least 2 months
have passed since the last dose. An unvaccinated 12-14 month old child
should receive one dose as a primary series, and a booster dose 2 months
later. Unvaccinated children 15-59 months of age need only a single dose
of any licensed conjugate Hib vaccine.
(Note: Defer the booster dose in healthy children until further notice
due to Hib vaccine shortage in 2008 [see box above].) |
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| A 4-year-old received dose
#3 of Hib at age 6 months. Does the child need dose #4? |
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| Yes. All children less than 5 years old need at least one dose
of Hib vaccine on or after the first birthday. The last dose should be
separated from the previous dose by at least 2 months.
(Note: Defer the booster dose in healthy children until further notice
due to Hib vaccine shortage in 2008 [see box above].) |
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| I've just evaluated a 7-year
old who does not have a record of receiving Hib vaccine. Would
a dose be indicated now? |
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| ACIP does not recommend routine Hib vaccination of healthy children
59 months of age or older, even if they have no prior history of Hib
vaccination. |
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| Reviewed on 12/08 |
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