The most recent comprehensive Advisory Committee on Immunization Practices (ACIP) recommendations for Hib vaccination were published in 2014 and are available on the CDC website at www.cdc.gov/acip-recs/hcp/vaccine-specific/hib.html. An ACIP update, adding Vaxelis (DTaP-IPV-Hib-HepB, MSP Company) as a preferred Hib-containing option for vaccination of American Indian/Alaska Native children was published in September 2024 and is also available at the link above. Guidance for Hib vaccination is also provided in the annual childhood immunization schedule, available at www.cdc.gov/vaccines/hcp/imz-schedules/child-adolescent-age.html.
Last reviewed:
January 21, 2025
Three monovalent Hib vaccines are available in the United States: PedvaxHIB (PRP-OMP, Merck), ActHIB (PRP-T, Sanofi) and Hiberix (PRP-T, GSK). These vaccines are composed of Hib purified polyribosylribitol phosphate (PRP) capsular polysaccharide chemically bound (conjugated) to a protein to enhance the quality of the immune response to PRP. All three vaccines are approved for infants in a 3- or 4-dose series (depending on brand).
Two combination vaccines containing Hib are currently available in the United States: Pentacel (DTaP-IPV/Hib, Sanofi) and Vaxelis (DTaP-IPV-Hib-HepB, MSP Company). Pentacel is licensed for use in children younger than age 5 years and contains Hib conjugate, DTaP, and inactivated polio vaccines; it is approved as a 4-dose series for infants at age 2, 4, 6, and 15 through 18 months, but it is not approved for use as the DTaP/IPV booster dose recommended at age 4 to 6 years. Vaxelis (DTaP-IPV-Hib-HepB) is licensed for use in children younger than age 5 years and is FDA-approved and recommended by CDC as a 3-dose primary series of Hib for infants at age 2, 4, and 6 months. Vaxelis is not approved for use as a Hib booster (4th) dose. Vaxelis contains the same PRP-OMP Hib antigen as PedvaxHIB, but in a reduced amount; like PedvaxHIB, it is an ACIP-preferred option for administration to American Indian and Alaska Native infants (who are at increased risk of early-onset invasive Hib disease) because it induces protective antibody levels after the first dose.
Last reviewed:
January 21, 2025
ACIP recommends routine administration of a conjugate Hib vaccine series for all infants beginning at age 2 months. Infants 2 through 6 months of age should receive a 3-dose series of ActHIB, Hiberix, Pentacel, or Vaxelis, or a 2-dose series of PedvaxHIB. The first dose can be administered as early as age 6 weeks, but not earlier. Hib-containing vaccine should not be given before 6 weeks of age. Doses given before 12 months of age should be separated by at least 4 weeks. A booster dose (which will be dose 3 or 4 depending on vaccine type used in primary series) of any Hib-containing vaccine is recommended at age 12 through 15 months and at least 8 weeks after the most recent Hib dose. Vaxelis is recommended only for the primary Hib series and is not recommended for use as a booster (4th) dose. A different Hib-containing vaccine licensed for a booster dose should be used.
Medically stable preterm infants should be vaccinated beginning at age 2 months according to the schedule recommended for other infants, on the basis of chronological age. For special situations in children, refer to the current CDC recommended immunization schedule Hib notes: www.cdc.gov/vaccines/hcp/imz-schedules/child-adolescent-notes.html.
Last reviewed:
January 21, 2025
Yes, for the primary series. If either ActHIB (PRP-T), Hiberix (PRP-T), Vaxelis (DTaP-IPV-Hib-HepB), or Pentacel (DTaP-IPV/Hib) is used for a routine primary series dose, a complete routine primary series consists of three doses. PedvaxHIB (PRP-OMP) requires a 2-dose primary series, but if administering a mixed-product primary series including only one dose of PedvaxHIB, a total of 3 doses is needed to complete the primary series.
Vaxelis is not recommended for use as a Hib booster (4th) dose. A different Hib-containing vaccine licensed for the booster dose should be used. If Vaxelis is inadvertently given as the booster dose, the dose does not need to be repeated with another Hib-containing vaccine, if the proper spacing of prior doses is maintained.
Last reviewed:
January 21, 2025
Pneumococcal conjugate vaccine (PCV), Haemophilus influenzae type b (Hib) vaccine, MenACWY, and meningococcal B vaccine should be given at least 14 days before a scheduled splenectomy, if possible. This is done so the patient is protected from these diseases before the spleen is removed; however, doses given during the 14 days before surgery also can be counted as valid. If the doses cannot be given prior to the splenectomy, they should be given as soon as the patient’s condition has stabilized after surgery. If PCV20 or PCV21 is given, pneumococcal polysaccharide vaccine (PPSV23) is not needed; if PCV15 is given, administer a dose of PPSV23 at least 8 weeks after the dose of PCV15 if the patient is age 2 years or older.
Last reviewed:
November 15, 2024