Hib Vaccine

[PCARN]

Hi Ladies- I would like to hear your opinions about the Hib vaccine. Whether or not you decided to give it, etc. My little one has gotten three doses so far and also had the titer test as well which showed that the booster is needed.  We selectively vaccinate and haven't given most of the recommended vaccines due to a prior reaction to what they think was Dtap. I've been trying to follow Dr. Sears' recommendations regarding this vaccine but am concerned about the susceptability period. I've read in his book it's five days while on other sites it said it could be three weeks? Is there anywhere I could get more information regarding this? Dr. Sears' himself had mentioned that this only applied to the old vaccine but from my research I've read there has been cases with the new vaccine as well?  I'm contemplating what's best to do. I would really appreciate your thoughts.  Thanks in advance.

[carriebft]

Dr Sears needs to update his book. The susceptability thing came from the old vaccine and has been shown to not be an issue with the newer conjugates. this has been pointed out to him numerous times. I do hope he will include it in a future revision as I know he now, like you mentioned, does tell people on his site that this is outdated information. (and perhaps its in the book now, too? I admit I am going by the last revision he did a year ago).

Where are you seeing that it is happening with the new conjugates?

[PCARN]

Carrie- I've read this in other vaccine books (Neil Miller's Vaccine book is one) as well as a few sites including the National Vaccine Information Center's site. It was also mentioned in a package insert of one of the vaccines that I found online. Seems from what I read it hasn't occured as often as the polysaccaride (sp?) vaccine but there have been reports made. Do you have any sites or information regarding what you mentioned, that it hasn't been shown to be an issue with the conjugate vaccine? I've been trying to gather as much information as I can and would appreciate it. Do you know how long the conjugate vaccines have been out? I read the archives regarding the Hib vaccine and it seems the last posts are several years old and I was wondering if that information was regarding the old vaccine or the new..

[carriebft]

The acthib insert, the one I believe you are referring to, tells us that, because antibody levels are not sufficient until 2 weeks after immunization, you can be infected by hib in that period. It does not mean there is an increased risk of hib in that period. The risk would be the same as if you had not been immunized because there would be no antibodies. does that make sense? with the polys, children under 15 months were not developing these antibodies at all or they were very very low. the poly wasn't efficiently protecting from colonization either.

In 1987, before widespread use of the conjugates, many kids were still becoming infected in those weeks after vaccination due to the above issues + the thought that the old hib vaccines might be lowering antibody levels in those kids who did not respond. This prompted the AAP to call for universal hib vaccination with the conjugates in a policy change statement. Since 1993 (i think? i have to look it up- i belive the policy took effect 1991), studies have not shown this gap period to be a problem due to herd immunity. You are protected by the herd in the 2 week gap + you aren't having those lower antibody issues.

And I will note that, even though most inserts tell you two week gap, studies typically show 1 week to sufficient antibodies...like this one:

http://linkinghub.elsevier.com/retrieve/pii/S0140673696063921

Edited by carriebft - 11/30/10 at 6:54am

[PCARN]

Thanks for the info. Carrie. The insert I read wasn't for the ActHib, it was for the other one on the market (can't think of the name off the top of my head).

Thanks again.