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News About Hib_vaccine

20-September-2008 09:55:51 - Hib vaccine Haemophilus influenzae type b vaccine Hib vaccine or PRP vaccine1 is a conjugate vaccine developed for the prevention of invasive disease caused by Haemophilus influenzae type b bacteria. The Centers for Disease Control and Prevention CDC has made recommendations for the use of the Hib vaccine2. Due to routine use of the Hib vaccine in the U.S. from 1980 to 1990, the incidence of invasive Hib disease has decreased from 40-100 per 100,000 children down to 1.3 per 100,0003. Vaccinations against Haemophilus influenzae Hib have decreased early childhood meningitis significantly in developed countries and recently in developing countries 4. Contents 1 History and Vaccine Composition 1.1 Polysaccharide Vaccine 1.2 Polysaccharide-Protein Conjugate Vaccine 1.3 Vaccine Combinations 2 Efficacy 3 Safety 4 Impact 4.1 Herd Immunity 5 Recommendations 6 Vaccination in the developing world 6.1 GAVI and the Hib Initiative 7 References 8 See also History and Vaccine Composition Polysaccharide Vaccine The first Hib vaccine licensed was a pure polysaccharide vaccine, first marketed in the US in 1985. 5 Similar to other polysaccharide vaccines, immune responses to the vaccine was highly age dependent. It was found to be ineffective in children younger than 18 months and was of variable effectiveness in older children. As a result, the age group with the highest incidence of Hib disease was unprotected, limiting the usefulness of the vaccine. The vaccine withdrawal from the market in 1988. Polysaccharide-Protein Conjugate Vaccine The short comings of the polysaccharide vaccine lead to the production Hib polysaccharide-protein conjugate vaccine. 6 Attaching Hib polysaccharide to a protein carrier greatly increased the ability of the immune system of young children to recognize the polysaccharide, and effectively fight the disease. There are currently three types of conjugate vaccine utilizing different proteins in the conjugation process, all of which are highly effective: tetanus toxoid, mutant diphtheria protein, and meningococcal group B outer membrane protein. Vaccine Combinations Multiple combinations of Hib and other vaccines have been licensed in the United States, reducing the number of shots necessary to vaccinate a child. Hib vaccine combined with diphtheria-tetanus-pertussis-polio vaccines ,and Hepatitis B vaccines are available in the US. The WHO has certified several Hib vaccine combinations, including a pentavalent diphtheria-pertussis-tetanus-hepatitis B-Hib, for use in developing countries. Efficacy Hib conjugate vaccines have been shown to be universally effective against all manifestations of Hib disease, with a clinical efficacy among fully vaccinated children has been estimated to be between 95-100%. The vaccine has also been shown to be immunogenic in patients who are at high risk of invasive disease. Hib vaccine is not effective against non-type B Haemophilus influenza. However, non-type B disease is rare in comparison to pre-vaccine era Haemophilus influenza B disease. Safety Clinical trials and ongoing surveillance have shown Hib vaccine to be safe. Adverse reactions to the vaccine are generally mild. The most common reactions are transient redness, swelling, or pain at the site of injection, occurring in 5-30% of vaccine recipients. More severe reactions are extremely rare. Impact Prior to introduction of the conjugate vaccine, Hib was a leading cause of childhood meningitis, pneumonia, and epiglottis in the United States, causing an estimated 20,000 cases a year in the early 1980s, mostly in children under 5 years old. Since routine vaccination, the incidence of Hib disease has declined by greater than 99%, effectively eliminating Hib as a public health problem. Similar reductions in disease occurred after introduction of the vaccine in Western Europe and developing countries. Herd Immunity Although Hib vaccine is given to children, Hib infections have also decreased in adults. This, effect, know as herd immunity, happened because prior to vaccination some children carried Hib in their nasal passages for extended times before they clear the infection. These Hib carrying children would regularly infect adults. Vaccinating children eliminated the source of the bacteria, reducing the rate of Hib disease in adults. Recommendations The CDC and WHO currently recommend that all infants should be vaccinated using a polysaccharide-protein conjugate Hib vaccine, starting after the age of 6 weeks. Specific immunization schedule depend on which vaccine is used and local recommendations. Vaccination in the developing world Introduction of Hib vaccine in developing countries lagged behind developed countries for several reasons. The expense of the vaccine was large in comparison to the standard EPI vaccines. Poor disease surveillance systems and inadequate hospital laboratories failed to detect the disease, leading many experts to believe that Hib did not exist in their countries. Finally, health systems in many countries were struggling with the current vaccines they were trying to deliver. GAVI and the Hib Initiative To remedy these issues the Global Alliance for Vaccines and Immunization GAVI took active interest in the vaccine. GAVI offers substantial subsidization of Hib vaccine to countries who are interested in using the vaccine, as well as financial support for vaccine systems and safe injections. Additionally, GAVI created the Hib Initiative to catalyze uptake of the vaccine. The Hib Initiative uses a combination collecting and disseminating existing data, research, and advocacy to assist countries in the making a decision abut using the Hib vaccine. Currently, 61 out of 72 low income countries are planning on introducing the vaccine by the end of 2009. 7 References ^ Haemophilus influenzae Type b Conjugate Vaccine Meningicoccal Protein Conjugate: Immunogenicity and Safety at Various Doses ^ CDC:Recommendation of the Immunization Practices Advisory Committee ACIP Polysaccharide Vaccine for Prevention of Haemophilus influenzae Type b Disease ^ CDC: Haemophilus influenzae Serotype b Hib Disease ^ GAVI Alliance: Deadly Disease Eliminated in Children under Five Years of Age in Uganda ^ Centers for Disease Control and Prevention. Epidemiology and Prevention of Vaccine-Preventable Diseases. Atkinson W, Hamborsky J,McIntyre L, Wolfe S, eds. 9th ed. Washington DC: Public Health Foundation, 2006. ^ Centers for Disease Control and Prevention. Epidemiology and Prevention of Vaccine-Preventable Diseases. Atkinson W, Hamborsky J,McIntyre L, Wolfe S, eds. 9th ed. Washington DC: Public Health Foundation, 2006. ^ http://www.hibaction.org/, accessed 6/26/2008 See also Conjugate vaccine Epiglottis Haemophilus influenzae v d e Vaccines, Vaccination, Immunization, and Inoculation see also artificial induction of immunity Development Adjuvants Cancer vaccines DNA vaccination HIV Live vector vaccine Models Timeline Trial Administration Global: GAVI Policy Schedule Vaccine injury USA: ACIP VAERS VSD Vaccine court Vaccines live Anthrax BCG tuberculosis Flu MMR MMRV PolioOPV Rotavirus Smallpox Varicella Yellow fever Inactivated/toxoid inactivated virus: Flu HAV PolioIPV inactivated bacteria/toxoid: DTwP conjugate: Hib PCV Other subunit: Anthrax DTaP HPV recombinant DNA: HBV other: Anthrax PPV Controversy General A-CHAMP MMR NCVIA Pox party Safe Minds Thiomersal See also List of vaccine topics Epidemiology Eradication of infectious diseases Retrieved from http://en..org/wiki/Hib_vaccine Categories: Vaccines Views Article Discussion this page History Personal tools Log in / create account Navigation Main page Contents Featured content Current events Random article Search Go Search Interaction Community portal Recent changes Contact Donate to Help Toolbox What links here Related changes Upload file Special pages Printable version Permanent link Cite this page Languages Español This page was last modified on 18 July 2008, at 10:07

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