Should I choose Hiberix or ActHiB for my 3 yr old DD? Urgent help needed please ...

[Blessed_Mom]

Hi,

Our DD (3 yrs) needs one more Hib dose considering she was 9 months when she got her first. That time single Hib shots weren't available at our peds and we went to the public health office nearby. Apparently now they have shut down their immunization clinics there because of lack of funding (eh?) and now I am not sure where can I find a single Hib Shot?

Other Peds' offices or someplace i am not thinking of/

TIA

Edited by Blessed_Mom - 5/16/12 at 7:37am

[AbbyGrant]

At one time there was a shortage of single Hib shots. I think that's not the case anymore, but I could be wrong. Your pediatrician might have them now.

[AbbyGrant]

According to the CDC, currently there is no shortage of single doses of Hib.

http://www.cdc.gov/vaccines/vac-gen/shortages/

Here's some info about the past shortage.

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5824a5.htm
 

[Blessed_Mom]

Oh no.. not because of any shortage. Apparently my peds' office never stocked single HiB shots!

Yeah - I thought that was crazy too.. 

[AbbyGrant]

I thought the booster was a single dose? That's why they were recommending no booster during the shortage.
 

[Blessed_Mom]

Now I am confused.

OK.. so my DD (3 years) got only one Hib when she was 9 months old.

Now we want to give her another.

what should  it be?

[AbbyGrant]

Sorry, I didn't mean to confuse you.   I just meant I thought the final dose (usually given between 12 to 15 months) was not as likely to be part of a combo shot like the ones given at a younger age usually are, so it would seem like pediatricians would have individual doses of Hib on hand. Also, it seems like they would need it for kids that are off schedule and who don't need it as part of a combo vaccine. Mine always seemed to to have single doses available even during the shortage for those that needed it. Maybe your pediatrician's office could order a single dose if they don't have it?

Edited by AbbyGrant - 5/15/12 at 1:32pm

[Blessed_Mom]

I had recently taken my DD to her Peds' and had asked about a single Hib shot. He again reiterated that they always carried Pentacel and not single HiBs.....

But today I called them to see if they would know where else i could get a single dose since I don't wnat to do the Pentacel. Well since WA state is going through a Pertussis epidemic right now.. the nurse answered that they are out of Pentacels and can offer me a single Hib shot (very mysterious.. makes me suspect that they are withholding the single HiBs for some kind of a reason... they always said they don't carry them and I am a bit surprised they have stocked them so fast)

Anyway so I asked her which HiB vax it was.. she was very confused by the question (I thought that Hib was manufactured by Sanoufi, Merck and also GlaxoSmithKline...).. We had gotten ActHiB the first time....and I wanted the same..

..she came back with ..it is by Sanoufi.

If she says it is a single dose HiB (and not a combo) and by Sanoufi... it should mean ONLY ActHiB right? OR can it mean anything else?

I kind of read that with HiB we need to keep the conjugate vax the same as possible throughout the series....

..am confused! (Again)

[AbbyGrant]

As far as I can tell, ActHIB is the only monovalent Hib made by Sanofi. http://www.cdc.gov/vaccines/about/terms/USvaccines.html

[Blessed_Mom]

AbbyGrant (or anyone who knows)

When you mentioned a booster did you mean it as something different from the normal HiB series that are given to infants?

Example - a DTaP is the series given to infants and toddlers but a very different booster is given to kids 7 or older - TDaP.

When you mentioned that toddlers older than 15 months are given a HiB booster - did you mean a shot of a different kind? OR does the Act HiB she is about to be given on Thursday morning count as the booster???

I read in another thread about DTaPs that even though a 5th dose is not necessary if the 4th has been given after age 4 years ..many nurses do NOT know this and will offer a 5 th dose anyway .

I don't want a similar misunderstanding or ignorance to happen with the HiB and give my 3 year old a shot she may not need after all (or may need a different version of... )

Thanks

Hope I wasn't too unclear?

[Blessed_Mom]

Is there an age when a HiB vax becomes no longer relevant (because a toddler is past the dangers of the severity of the illness?)

I don't even know what I am asking really 

I guess I am just scared about her getting vaxed tomorrow ... we have given her DTaP, IPV and a HiB so far and HiB was the vax I was most uncomfortable with (especially the - if you kill that particular bacteria more abhorrent bacteria take their place kind of reports)....

...DTaP and IPV are so much easier on me.

I hate to be in this state. I have no right or wrong stance - but we had decided to give DD a few select vaxes and this was one of them! I hate hate hate it!

Why cannot there be safer vaccines? 

[AbbyGrant]

I just seem to be creating confusion, so I should probably just shut up. But I will just keep it very brief. It sounds like your pediatrician has ActHIB although it would be wise to confirm if that is what you want. One dose of ActHIB will complete the series (although technically I think you could use any Hib vaccine in this case). 

In case you don't know about it already, the CDC has an interactive catch up scheduler now where you just type in your child's age and what they've had and when they had it, and it will tell you what they need to get caught up. 

https://www.vacscheduler.org/scheduler.html?v=patient

[AbbyGrant]

Originally Posted by Blessed_Mom 

Is there an age when a HiB vax becomes no longer relevant (because a toddler is past the dangers of the severity of the illness?)

I don't even know what I am asking really 

I guess I am just scared about her getting vaxed tomorrow ... we have given her DTaP, IPV and a HiB so far and HiB was the vax I was most uncomfortable with (especially the - if you kill that particular bacteria more abhorrent bacteria take their place kind of reports)....

...DTaP and IPV are so much easier on me.

I hate to be in this state. I have no right or wrong stance - but we had decided to give DD a few select vaxes and this was one of them! I hate hate hate it!

Why cannot there be safer vaccines? 

I think your daughter is entering a time where the vaccine may no longer be super relevant. It's not given after 5. I've read, although I don't have time right now to cite a source, that two thirds of cases are in children under 3 and that it peaks around 6 months. 

[Blessed_Mom]

Originally Posted by AbbyGrant 

I just seem to be creating confusion, so I should probably just shut up. But I will just keep it very brief. It sounds like your pediatrician has ActHIB although it would be wise to confirm if that is what you want. One dose of ActHIB will complete the series (although technically I think you could use any Hib vaccine in this case). 

In case you don't know about it already, the CDC has an interactive catch up scheduler now where you just type in your child's age and what they've had and when they had it, and it will tell you what they need to get caught up. 

https://www.vacscheduler.org/scheduler.html?v=patient

Err.... the bolded part. That is what I am trying to do.....

..is that what I want?

OR should I be getting a more benign (I can hope, can't I?) booster at this age?

Her first and only was ActHiB at 9 months.

[Blessed_Mom]

Originally Posted by AbbyGrant 

I just seem to be creating confusion, so I should probably just shut up.  But I will just keep it very brief. It sounds like your pediatrician has ActHIB although it would be wise to confirm if that is what you want. One dose of ActHIB will complete the series (although technically I think you could use any Hib vaccine in this case). 

In case you don't know about it already, the CDC has an interactive catch up scheduler now where you just type in your child's age and what they've had and when they had it, and it will tell you what they need to get caught up. 

https://www.vacscheduler.org/scheduler.html?v=patient

Tee Hee.. that link is sooo sucky! (I don't mean anything mean to you AbbyGrant.. thank you for that link)

..but it gave me all vaxes to get today as a Catch-up dose in red   Yeah right!

[AbbyGrant]

Oh I didn't mean it like you should look into whether you really want that one like there was something wrong with it.  I just meant it would be wise to confirm with them that that is indeed what they have if you are set on wanting to do the same vaccine as she had before. There is certainly nothing wrong with wanting to do that. It's my understanding that any of the available Hib vaccines would work in this particular case though. I have no idea if Hiberix (the booster only dose) is "more benign."

[Blessed_Mom]

Ah-ha!

Finally :)

So Hiberix is what is the 'booster' is it?

Off to research!

[AbbyGrant]

Originally Posted by Blessed_Mom 

Tee Hee.. that link is sooo sucky! (I don't mean anything mean to you AbbyGrant.. thank you for that link)

..but it gave me all vaxes to get today as a Catch-up dose in red   Yeah right!

Oh yeah, I should have mentioned to just ignore the ones you don't want.    I've found it helpful to confirm if I've interpreted some of the more cryptic footnotes correctly on the schedule though. 

[Blessed_Mom]

Gak!

http://us.gsk.com/products/assets/us_hiberix.pdf

[Taximom5]

Blessed Mom, if you go through with the actual appointment to give your child the vaccine, PLEASE ask to see the package and package insert of the vaccine.

It doesn't matter how much you annoy the nurse. Or doctor, for that matter.

They are human. They make mistakes.  And sometimes they are not honest.

Back in 2004, our pediatrician's nurse INSISTED that all their vaccines were thimerosal-free, but I watched her draw up the syringe from a multi-use vial.  
It took me at least 10 minutes of arguing to convince her to show me the package insert, where I showed her where thimerosal was clearly listed as an ingredient. I don't think she was being dishonest--I think she honestly didn't know.  It's not part of nursing school to learn about vaccine ingredients, unfortunately.  The most they're taught is to have a patient at-risk for reactions to stay in the office for 15-30 minutes in case of fainting. And that's only this year's nursing school/nurse-practitioners who have been taught this in school.

Some pediatricians give older children adult versions of vaccines--same strength, but the adult version comes in the less expensive, multi-use (thimerosal-preserved) vials. Thimerosal has only been discontinued in pediatric vaccines sold in the US.  Adult vaccines sold in the US can be thimerosal-preserved, as are pediatric vaccines made in the US and exported to third-world countries.

Given that your pediatrician's office has already been a bit dodgy regarding which vaccine they actually stock, well, that raises red flags for me.