Hib

onlyAngil · 11-07-2009, 01:48 AM

I am working my way down the list of vax.s, HIB is up first.

I know the basics: uncommon to start with even more so if BFing and staying home and almost unheard of after 3ish, could contain aluminum, one is more vulnerable to HIB for about a week after the HIB vax.

What else could I want to know/ would you really want to share with me?
Benefits?
(I know that it would greatly lower the chances of getting HIB but I feel the need to include this in my list.)
Risks?
(I have heard the vax is linked with diabetes. Is this true? How so?)
Alternatives?
(This is a big one for me, what are my other choices?!?!?)
What if I do nothing and ,say, DD gets HIB then what?
(Is antibiotics our only choice?)

TIA!

gcgirl · 11-17-2009, 12:19 PM

This one still bothers me. We didn't get it for DS, who is now two, and the main reason is serotype conversion and the news that people who have had the vax have higher levels of staph in their nasal passages. Changing the balance of bacteria like that really worries me.

It IS rare, but it does occur, and I don't really know what to do to prevent it. We BF'd for two years but are now done, but I've read that most HIb cases now occur in children under age five, not under age TWO, like it was before the vax. So it makes me nervous.

Also, it seems that the shot has one of the best safety profiles of any vax out there if you discount the wider public health implications. I'm not worried about the vax itself, just the serotype conversion/bacteriological issues. I seriously doubt there is any real data to back up the diabetes connection, but vaxes are underresearched IMO.

carriebft · 11-18-2009, 08:33 AM

The newer hib vaccine is actually not associated with higher risk of hib after the shot. Dr Sears has this wrong in his book as well and has since admitted it on his vaccine board.

Some hib shots don't contain aluminum-- we now have 2 aluminum free vaccines, though I forget the name of the second one and it's only for booster doses. ACTHib is the brand name of the one that is used for all doses.

It is my opinion that there is no evidence to support the diabetes claim and much evidence against it. The one study that is used to support this claim is pretty poorly done.

Invasive hib is a very nasty disease with high complication and death rates. We had 7 cases here recently, 3 died and the other 4 had meningitis/pneumonia/etc. Epiglotitis is another concern.

The vaccine is highly effective and safe, so we go for it.

gcgirl · 11-18-2009, 01:23 PM

Quote:

Originally Posted by carriebft

Invasive hib is a very nasty disease with high complication and death rates. We had 7 cases here recently, 3 died and the other 4 had meningitis/pneumonia/etc. Epiglotitis is another concern.

Do you have any insight on the under two/under five question? Now that DS is two, I feel a *little* better about his not having had the shot, but I've been hearing that the risk of invasive HIb has gone up to age five, not age two.

And while I don't questions the safety OR efficacy of the vax, I DO question the larger public health issues.

carriebft · 11-18-2009, 02:17 PM

I have always heard that the highest risk is to two but that there is still high risk until 5. I think the 7 cases around here demonstrate that well-- majority were 0-2 but 2 of the cases were in 3+ yrs and they both died. The other death was a 2 yr old. the rest suffered meningitis and sepsis. 6 unvaccinated, 1 had had one dose.

Hib was always called the greatest cause of meningitis in kids under the age of 5. I have not seen evidence that there has been any great shift in the disease since the vaccine.

There is a shift in that the hib meningitis for kids 5 and under is practically eliminated, so most cases are in adults now-- but they aren't *new* cases, it's not that adult case numbers are rising. You just have eliminated a huge pool of cases with the vaccine in young children.

http://content.nejm.org/cgi/content/abstract/337/14/970
http://jama.ama-assn.org/cgi/content/abstract/269/2/221

just the first two that popped up when searching this

carriebft · 11-18-2009, 02:21 PM

http://journals.lww.com/pidj/Citatio...type_b.36.aspx

Even in 1987 they were talking about hib as being the cause of meningitis in kids 5 and under.

also here, talking about how 90% of hib infections are in the first 5 yrs of life with a peak in the first year.

http://www.jstor.org/pss/30104823

japonica · 11-18-2009, 05:00 PM

The risk is not a static rate under 5. There was a good thread that discussed this:

http://www.mothering.com/discussions....php?t=1051281

carriebft · 11-18-2009, 08:10 PM

Right, 90% under 5 with a peak in the first year of life. Looking at the 7 PA cases: 4 under one, 1 two, 2 over two. Pretty much dead on.