on the fence with HIB-need opinions - Mothering Forums

Forum Jump: 
Reply
 
Thread Tools
#1 of 100 Old 01-20-2009, 01:27 PM - Thread Starter
 
nycmom18's Avatar
 
Join Date: Dec 2008
Location: nyc
Posts: 852
Mentioned: 1 Post(s)
Tagged: 0 Thread(s)
Quoted: 2 Post(s)
Hello,

we have not yet vaxed our 8 month old ds-which i am mostly confident in. the only thing that is really haunting me still for this period in his life is HIB.

My ds is basically exclusively breastfed still, he has started about a teaspoon a day of solids, and he stays home with me all day everyday.

This is what i know, (so i believe):

-HIB is a very horrible damaging and fatal bacteria-however not around a lot anymore

-by doing the vaccine for HIB i am putting my ds body in a vulnerable state for other serotypes. but is this the sacrifice we make for such a horrible bacteria? and we just continue to make vaccines for the other serotypes eventually?

-meningitis is a state of health-not a disease*please help me understand why people say this. because it seems like an excuse sometimes to not get the vaccine, but i know if my child contracted HIB bacteria, and got meningitis and maybe even worse from it, i would NEVER forgive myself for not preventing it from happening.

i am forgetting a lot of other questions i think about daily right now, but i am open to all opinions or pm me as well. thanks for taking the time!
nycmom18 is offline  
Sponsored Links
Advertisement
 
#2 of 100 Old 01-20-2009, 02:49 PM
 
just_lily's Avatar
 
Join Date: Feb 2008
Posts: 2,153
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by nycmom18 View Post
This is what i know, (so i believe):

-HIB is a very horrible damaging and fatal bacteria-however not around a lot anymore
Actually, most cases of Hib are benine. There may be no symptoms present, or they are just passed off as the common cold. There are very few cases of Hib diagnosed because in most instances there won't be any laboratory testing if someone just seems to have a cold.

-by doing the vaccine for HIB i am putting my ds body in a vulnerable state for other serotypes. but is this the sacrifice we make for such a horrible bacteria? and we just continue to make vaccines for the other serotypes eventually? I have never heard that by getting the vax you actually become more vulnerable to other strains. Someone else will have to speak to this. Of course the pharma plan is to just make more and more vax... but where does it end, and what damage are we doing to our children to get there? I am most concerned about the potential link between the Hib vax and Type 1 Diabetes. A quick google search will bring up all kinds of information on this.

-meningitis is a state of health-not a disease*please help me understand why people say this. because it seems like an excuse sometimes to not get the vaccine, but i know if my child contracted HIB bacteria, and got meningitis and maybe even worse from it, i would NEVER forgive myself for not preventing it from happening. The reason why people point out that meningitis is a condition is because you can't vaccinate against all kinds of meningitis. It is like trying to vaccinate against fever. There are hundreds of bacterial and viral strains that can cause meningitis and we only vaccinate against 9 of them (Hib, Meningicoccal, and 7 in Pc). I don't think it is an excuse, just a statement of fact. With serotype replacement you have to understand that you aren't reducing your child's chance of contracting meningitis, just the chance of getting meningitis caused by Hib.
Hib was the vax that my doctor really went after me about, and I have to admit that I did some second guessing. But when I thought about it logically I realized that I had never even heard of Hib until I had a baby. Everyone I know over the age of about five has never been vaccinated for this, and they all managed to survive childhood.

Serotype replacement is definitely a factor. The link to diabetes is concerning. And for me, it is also just too new. I have a problem injecting my child with something that hasn't even been around long enough that we know how long it takes to wear off.

And if you are nursing, that provides a great deal of protection.

Wife to DH (06/10) and Mummy to DD (07/08).

just_lily is offline  
#3 of 100 Old 01-20-2009, 03:41 PM
 
kiara7's Avatar
 
Join Date: Feb 2008
Posts: 997
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
You can do a search on pubmed for studies on hib in breastfed babies. There was a swedish study I think, that found 0 incidence of hib bacteria in breastfed babies.
kiara7 is offline  
#4 of 100 Old 01-22-2009, 04:53 AM
 
gcgirl's Avatar
 
Join Date: Apr 2007
Posts: 2,311
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by kiara7 View Post
You can do a search on pubmed for studies on hib in breastfed babies. There was a swedish study I think, that found 0 incidence of hib bacteria in breastfed babies.
It wasn't zero, but it was much lower in babies the longer they were breastfed.

And we don't do Hib or Pc because of the serotype conversion. It's totally pointless now.
gcgirl is offline  
#5 of 100 Old 01-22-2009, 05:23 AM
 
Sileree's Avatar
 
Join Date: Aug 2006
Location: SE Michigan
Posts: 1,011
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
I hope this info is helpful.

Reported Cases Per Year Ages <5
2001 – 27
2002 – 34
2003 – 32
2004 – 19
2005 – 9
2006 – 29
2007 – 17

[CDC. Surveillance Summaries, 2001-2007. MMWR.]

“Ninety percent of individuals carry Hib bacteria in their nose and throat without showing signs of the disease. The organism enters the body through the nasopharynx. Organisms colonize the nasopharynx and may remain only transiently or for several months in the absence of symptoms (asymptomatic carrier). Nontypeable (unencapsulated) strains are also frequent inhabitants of the human respiratory tract.”

[The Pink Book, Chapter 9]

"There is little risk of getting the disease after age 5."

(Also from The Pink Book)

Major Clinical Manifestations
*Meningitis (50-65% of total cases, mortality rate 2-5%, neurological sequeale in 15-30% of survivors)
*Epiglottis (17% of cases)
*Arthritis (8%)
*Skin infection (6%)
*Pneumonia (15%)
*Bone infection (2%)

Breastfeeding Decreases Risk
Quote:
“The association of decreased risk for invasive Hi infection and long duration of breastfeeding was persisting beyond the period of breastfeeding itself. This finding supports the hypothesis of a long-lasting protective effect of breastfeeding on the risk for invasive Hi infection.”
[“Protective Effect of Breastfeeding on Invasive Haemophilus influenzae Infection: A Case-Control Study in Swedish Preschool Children.” International Journal of Epidemiology.]

Quote:
“Breastmilk has a high concentration of secretory immunoglobulin and potentially could serve as a source of passive antibody protection of infants against systemic invasion by Haemophilus influenzae type b.”
[“Breastmilk Antibody to the Capsular Polysaccharide of Hib.” Journal of Infectious Diseases.]

Short-term Side Effects, Clinical Trials on Package Insert
ACTHIB
-All trials include children vaccinated conmittantly with DTP, which is no longer used
PEDVAXHIB
-All trials include children vaccinated conmittantly with DTP and OPV, which are no longer used today
HIBTITER (only vaccine with trials in which children were given just the Hib and side effects were monitored)
-401 infants 1-6 months old given three doses alone, DTP two weeks later
-Adverse events recorded for two days
*33% irritability
*22% sleepiness
*9.5% prolonged crying >4 hours (!)
*6% appetite loss
*2.2% vomitting
*0.4% diarrhea
*0.2% rash
-354 children 15-23 months given one dose
-Adverse events recorded for one day
*2.5% diarrhea
*1.4% vomitting
*1.1% prolonged crying >4 hours
*0.5% rash

Side Effects in Medical Literature
*Antibody levels decrease immediately following vaccination (Daum, 1989; Marchant, 1989)
*2-6 times increased risk of Hib disease in seven days following vaccination (Black, 1988; Harrison, 1988; Osterholm, 1988; Shapiro, 1988; Hiner, 1988)
*Increased risk of seizures?
Vadheim et al:
-Group #1: vaccinated with DTP, OPV and Hib, had 5 seizures within 48 hours and 3 more within 3-14 days
-Group #2: vaccinated with DTP, OPV and Hep B, had 0 seizures within 48 hours and 2 within 3-14 days.
*GBS?
*Transverse myelitis?
*Thrombocytopenia?
*Causal relationship to diabetes (Classen, 1999; Karvoven, 1999)

Vaccine Effectiveness

Quote:
“Vaccine effectiveness was estimated to be 56.7%.”
[“Estimating Haemophilus Influenzae Type B Vaccine Effectiveness in England and Wales by Use of the Screening Method.” Journal of Infectious Diseases.]

Quote:
“By using conditional logistic regression the vaccine effectiveness [against pneumonia] was estimated as 31.0%.”
[“Effectiveness of Haemophilus Influenzae B Conjugate Vaccine on Childhood Pneumonia: A Case-control Study in Brazil.” International Journal of Epidemiology.]

“In 1998–2000… thirty-two percent of children aged 6-59 months with confirmed type b disease had received 3 or more doses of the vaccine…”

[CDC. “Progress Toward Elimination of Haemophilus influenzae Type B Disease Among Infants and Children – United States, 1998–2000.” MMWR.]

Serotype Replacement

Quote:
“We show… an increase in virulence of non-b serotypes; and a concomitant increase in NC strains… Reduction of Hib carriage may open ecological niches for H. influenzae nontype-b strains and therefore potentially increase the risk of colonization and invasive disease by these strains.”
[“Emergence of Nonencapsulated and Encapsulated Non-B-Type Invasive Haemophilus Influenzae Isolates in Portugal 1989-2001.” Journal of Clinical Microbiology.]

Quote:
“In addition to the proportional increase in cases of nontype b H. influenzae disease in the post H. influenzae type b vaccine era, the incidence of invasive H. influenzae disease was found to be approaching the rates of H. influenzae type b disease that were documented in the prevaccine period. Fifty-six percent of invasive disease now occurs in individuals aged >10 years.”
[“Characterization of Invasive Haemophilus Influenzae Disease in Manitoba, Canada, 2000-2006: Invasive Disease Due to Non-type B Strains.” Clinical Infectious Diseases.]

Quote:
“The incidence of Hib meningitis decreased 69% during the 1-year period after initiation of Hib immunization (from 2.62 to 0.81 cases/100,000 person-years; P<.001). In contrast, the incidence for H. influenzae type a meningitis increased 8-fold. Therefore, Hib immunization contributed to an increased risk for H. influenzae type a meningitis through selection of circulating H. influenzae type a clones.”
[“Prevention of Haemophilus Influenzae Type b (Hib) Meningitis and Emergence of Serotype Replacement with Type A Strains After Introduction of Hib Immunization in Brazil.” Journal of Infectious Diseases.]

intactivist.gif  ribbonpb.gif RN student, bellycast.gif birth doula since 2006
Sileree is offline  
#6 of 100 Old 01-23-2009, 09:09 PM
 
carriebft's Avatar
 
Join Date: Mar 2007
Posts: 6,219
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
http://children.webmd.com/vaccines/n...ccinated-child

5 hib cases in outbreak. 3 unvaccinated- 1 died. 1 partially vaccinated but not done with series and 1 vaccinated but with immune deficiency.

so this can go either way I guess. most were unvaccinated or not totally vaccinated, but one vaccinated child also got it.

"Parents are simply trustees; they do not own the bodies of their children"-Norm Cohen  Martial arts instructor intactlact.gifhomebirth.jpgnak.gif and mom to 4: DD1 (1/05) DS (7/06) DD2 (5/08) DD3 (2/11)
carriebft is offline  
#7 of 100 Old 01-28-2009, 10:53 PM
 
dessismama's Avatar
 
Join Date: Mar 2005
Posts: 677
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
The vaccinated child was immunocompromised so this explains why she/he was so suseptible.
dessismama is offline  
#8 of 100 Old 01-28-2009, 11:36 PM
 
mamakah's Avatar
 
Join Date: Nov 2008
Posts: 757
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 2 Post(s)
When you have some time (about an hour) you should listen to this...
http://www.hpakids.org/RadioShow.htm
listen to #5 aired on OCT 19th.
I just listened to it today and they talked quite a bit about Hib and other VPDs. One point they had was of course, the breastfeeding thing, but also that we all have the hib bacteria in and around us. They said that when someone has a bad diet of junk food, sugar, bread etc. Our immune cells are not coated with a certain sugar that recognizes the hib bacteria as friendly. Thus, attacking it like an enemy, resulting in the battle of the hib bacteria and the immune system.
This brought me so much comfort, and made it an easy explanation to my hubby. We both laughed at the analogy I used.
The immune cells are having a party drinking too much (in this case to much junk and sugar), this intoxicates them and makes them pick a fight with one of their roommates that they have lived harmonyously (sp?) with for some time. This result in a viscious brawl that only one of them wins in the end! Had the Immune cells not been so chemically altered (sugar and junk again) they would have never picked a fight with their roomies Hib and the fight wouldn't have happened.
mamakah is offline  
#9 of 100 Old 01-31-2009, 12:29 PM
 
Lazy Gardens's Avatar
 
Join Date: Dec 2008
Posts: 245
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by nycmom18 View Post
-by doing the vaccine for HIB i am putting my ds body in a vulnerable state for other serotypes.
No, you are not. The other serotypes can infect an unvaccinated child just as readily as they can a vaccinated one.

Also, the other serotypes, for some complex biochemical reasons, are far less likely to cause the fast-moving meningitis that type b does.
Lazy Gardens is offline  
#10 of 100 Old 02-09-2009, 01:34 AM
 
mamakay's Avatar
 
Join Date: Apr 2005
Location: in la la land, or so they say...
Posts: 8,332
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 13 Post(s)
Quote:
Originally Posted by Lazy Gardens View Post
No, you are not. The other serotypes can infect an unvaccinated child just as readily as they can a vaccinated one.
Doesn't that depend on whether or not the unvaccinated child is presently colonized with Hib?

Quote:
Also, the other serotypes, for some complex biochemical reasons, are far less likely to cause the fast-moving meningitis that type b does.
Hia can be very similar.


http://pediatrics.aappublications.or...rint/108/1/e18

Quote:
We describe 5 cases of invasive disease, including
4 cases of meningitis in young children attributable
to H influenzae serotype a in Utah during a 10-month
period. Three cases were attributable to a unique
strain that possesses a deletion mutation associated
with invasive strains of Hib but not normally found
in noninvasive strains. Two of these cases, described
below, were strikingly reminiscent of severe disease
caused by Hib.
Their follow-up study was interesting, too.
http://jcm.asm.org/cgi/reprint/40/4/1264

Then there's this:

Quote:
In addition to the proportional increase in cases of non-type b Haemophilus influenzae disease in the post-H. influenzae type b vaccine era, the incidence of invasive H. influenzae disease was found to be approaching the rates of H. influenzae type b disease that were documented in the prevaccine period. Fifty-six percent of invasive disease now occurs in individuals aged >10 years.
Of course, that's all "invasive disease" and not just "fast moving meningitis".


ETA:
...just found this, too...

http://www.ncbi.nlm.nih.gov/pubmed/17984810

Quote:
Invasive infections caused by haemophilus influenzae serotypes in twelve Canadian IMPACT centers, 1996-2001.
Quote:
Mean duration of hospitalization, need for admission to a pediatric intensive care unit, and case fatality rates were similar for the cases because of Hib, Hia, Hif, and nontypable serotypes.
mamakay is offline  
#11 of 100 Old 02-21-2009, 01:16 PM
 
LilacMama's Avatar
 
Join Date: Aug 2008
Location: VA
Posts: 380
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by Sileree View Post

[CDC. Surveillance Summaries, 2001-2007. MMWR.]

“Ninety percent of individuals carry Hib bacteria in their nose and throat without showing signs of the disease. The organism enters the body through the nasopharynx. Organisms colonize the nasopharynx and may remain only transiently or for several months in the absence of symptoms (asymptomatic carrier). Nontypeable (unencapsulated) strains are also frequent inhabitants of the human respiratory tract.”

[The Pink Book, Chapter 9]
Wow, now I'm totally confused. On page 2 of the downloadable PDF on HIB from The Pink Book, it says that HIB could be isolated in the noses/throats of 0.5-3% of young children and was extremely rare in adults, in the pre-vaccine era.

The prevalence of the bacteria has HUGE impact on my decision to give this vax or not. Is the CDC contradicting themselves or am I missing something in my understanding?
LilacMama is offline  
#12 of 100 Old 02-21-2009, 04:25 PM
 
mamakay's Avatar
 
Join Date: Apr 2005
Location: in la la land, or so they say...
Posts: 8,332
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 13 Post(s)
The prevalence of hib carriage in all age groups is way down now compared to the prevaccine era. This is the most recent/current evidence I've been able to locate:

http://pediatrics.aappublications.or...l/108/4/e60#T1

Quote:
In Amish community A, pharyngeal swabs were obtained from 144 (93%) of 155 residents in participating households. Five residents (3%) were carriers of Hib, and 3 households (9%) had 1 or more Hib carriers (Table 1). In Amish community B, pharyngeal swabs were obtained from 154 (86%) of 180 residents. Thirteen (8%) were Hib carriers, and 8 (28%) of 29 households had 1 or more Hib carriers. In the non-Amish comparison group, pharyngeal swabs were obtained from 136 (56%) of 242 total household members . None of the participants were carriers.
But it's not completely eliminated nationally, as we can see from the small number of invasive hib cases we still get a year now.

If it's still floating around at a low level, that means kids are still possibly going to encounter it eventually, just at an older age than it was prevaccine.
mamakay is offline  
#13 of 100 Old 02-23-2009, 04:38 PM
 
Spectrolite's Avatar
 
Join Date: Feb 2009
Posts: 117
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Mean duration of hospitalization, need for admission to a pediatric intensive care unit, and case fatality rates were similar for the cases because of Hib, Hia, Hif, and nontypable serotypes.

from
http://www.ncbi.nlm.nih.gov/pubmed/17984810
Invasive infections caused by haemophilus influenzae serotypes in twelve Canadian IMPACT centers, 1996-2001.

Quote:
"...the incidence of invasive H. influenzae disease was found to be approaching the rates of H. influenzae type b disease that were documented in the prevaccine period. Fifty six percent of invasive disease now occurs in individuals aged over 10 years. "
from
"Characterization of Invasive Haemophilus Influenzae Disease in Manitoba, Canada, 2000-2006: Invasive Disease Due to Non-type B Strains"





Have any of you found other studies that give evidence of this??

What is the major cause of fatal bacterial meningitis today, now that Hib is nearly out of the question?
Spectrolite is offline  
#14 of 100 Old 02-23-2009, 07:06 PM
 
mamakay's Avatar
 
Join Date: Apr 2005
Location: in la la land, or so they say...
Posts: 8,332
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 13 Post(s)
Quote:
Have any of you found other studies that give evidence of this??
Not that actually compared it to the incidence of invasive disease before the introduction of the Hib vaccine like that study you posted does. But we do have extremely strong evidence that replacement happens:


adults in England after Hib immunization in kids:

http://www.ncbi.nlm.nih.gov/sites/en...t=AbstractPlus

Quote:
Though numbers of Hib infections in adults fell after the introduction of Hib vaccines for children (P = 0.035), and there was no increase in infections caused by other capsulated Hi serotypes, total numbers of invasive Hi infections increased due to a large rise in infections caused by non-capsulated Hi (ncHi) strains.
(noncapsulated is the same thing as "nontypeable")

Same thing in adults in the US:

http://www.ncbi.nlm.nih.gov/sites/en...indexed=google

Quote:
Nontypeable H. influenzae disease accounted for the greatest proportion of cases (35.8%-61.5%) in all but 1 age group. The number of cases of invasive nontypeable H. influenzae disease increased by 657%, from a low of 7 cases in 1996 to a high of 53 cases in 2004; as a proportion of annual cases, nontypeable H. influenzae disease increased from 17.5% in 1996 to 70.7% in 2004. Overall, the case-fatality rate was 12.7%, with the highest rate observed in persons aged > or = 65 years (20.6%). The case-fatality rate was similar for the hospital discharge database and for Indiana, Maryland, Oregon, and Wisconsin (range, 12.9%-18.2%).
Scroll about 2/3rds of the way down here and watch the total cases of h-flu from 1991 onward:

http://www.cdc.gov/vaccines/pubs/pin...ses&deaths.pdf

And here you can see that Hib conjugate vaccine uptake in 1992 was still only 28%:

http://www.cdc.gov/vaccines/pubs/pin...G/coverage.pdf

Here's some raw European data you can look at:
http://www.euibis.org/documents/2006_hib.pdf

Look at table 4 on page 21. Check out the "overall incidence" line. There's an overall slight increase since 1999.

Now go down further to figure 4 on page 24. B goes down, and the nontypeable/noncapsulated goes up. Of course that's just the "proportional to one another" cases...but remember the "overall incidence" from table 4...the total cases have gone UP. The increase in Nthi is "absolute"...not just "proportional".

Now go down to page 29 and look at figure 6. That's what you'd expect, since the vax is effective against serotype B.

And now go down to figure 10, page 34. Is it what you were expecting? See the pattern yet? lol

If that's a coincidence, it is one heck of one, huh?
Especially interesting in tables 6 and 10 are the weird spikes in 2002. Not sure what to make of that.
mamakay is offline  
#15 of 100 Old 02-24-2009, 05:57 AM
 
Spectrolite's Avatar
 
Join Date: Feb 2009
Posts: 117
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Ok, so what the numbers are saying is that the morbitidy and mortality of non-typable H infections is not yet at the same number as they were with HiB in the pre vaccine days, but they sure seem to be getting there.

So we are in sort of a lull right now with bacterial meningitis? In between high rates of HiB cases and possible upcoming high rates of non-HiB cases?
Spectrolite is offline  
#16 of 100 Old 02-24-2009, 03:40 PM
 
mamakay's Avatar
 
Join Date: Apr 2005
Location: in la la land, or so they say...
Posts: 8,332
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 13 Post(s)
Quote:
Originally Posted by Spectrolite View Post
Ok, so what the numbers are saying is that the morbitidy and mortality of non-typable H infections is not yet at the same number as they were with HiB in the pre vaccine days, but they sure seem to be getting there.

So we are in sort of a lull right now with bacterial meningitis? In between high rates of HiB cases and possible upcoming high rates of non-HiB cases?
Maybe. Looking at the CDC's appendix g data, it looks like "invasive h-flu" (this will include bacteremia, pneumonia, etc in addition to meningitis) is very nearly back to where it was when the hib vaccine was introduced. But it might be less meningitis and more bacteremia or something.
I haven't found any good data going back to 1990 or 1991 that tracked, for the whole population, what percentage of h-flu cases were meningitis vs. "other" types of invasive disease.

A point that can be made in favor of elimination of Hib, is that it is good for pediatric health (so far), even if that's at the expense of adults getting more invasive h-flu infections. I'm just not sure about the ethics of that sort of immunization program.
mamakay is offline  
#17 of 100 Old 02-24-2009, 06:58 PM
 
Spectrolite's Avatar
 
Join Date: Feb 2009
Posts: 117
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
But so far those invasive diseases seen in adults have not been so fatal, no? More easily treatable than that fast-moving Hib meningitis?
Spectrolite is offline  
#18 of 100 Old 02-24-2009, 07:06 PM
 
mamakay's Avatar
 
Join Date: Apr 2005
Location: in la la land, or so they say...
Posts: 8,332
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 13 Post(s)
Quote:
Originally Posted by Spectrolite View Post
But so far those invasive diseases seen in adults have not been so fatal, no? More easily treatable than that fast-moving Hib meningitis?
Probably. Either that, or medicine has improved significantly in the past 20 years. Maybe a bit of both.

Don't forget this, too:

Quote:
Mean duration of hospitalization, need for admission to a pediatric intensive care unit, and case fatality rates were similar for the cases because of Hib, Hia, Hif, and nontypable serotypes.
But that's just kids. Maybe adults are less likely to die from invasive NTHi infection.
mamakay is offline  
#19 of 100 Old 02-24-2009, 07:11 PM
 
anewmama's Avatar
 
Join Date: Feb 2007
Posts: 1,485
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Mamakay, you made a point in this thread or somewhere else about HiB being colonized later in children due to it being less in circulation. So for children not vaccinated, their risk factor could at a later age, I think you said 4?, would almost be that of a 6 month old. I know I am saying this badly. But do you think that one dose of HiB for an over 2 year old child would not be a bad thing given the risks of an older child being more like a younger child?

Can you re-state what you said? I think I asked you this in another thread but I lost the thread. Sorry if this hijacks this discussion....
anewmama is offline  
#20 of 100 Old 02-24-2009, 08:11 PM
 
mamakay's Avatar
 
Join Date: Apr 2005
Location: in la la land, or so they say...
Posts: 8,332
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 13 Post(s)
Quote:
Originally Posted by anewmama View Post
Mamakay, you made a point in this thread or somewhere else about HiB being colonized later in children due to it being less in circulation. So for children not vaccinated, their risk factor could at a later age, I think you said 4?, would almost be that of a 6 month old. I know I am saying this badly. But do you think that one dose of HiB for an over 2 year old child would not be a bad thing given the risks of an older child being more like a younger child?

Can you re-state what you said? I think I asked you this in another thread but I lost the thread. Sorry if this hijacks this discussion....
I understand what you're asking. In a nutshell, I think it is possible that a 4 yo exposed to hib for the first time might be about as at risk of serious disease as 6 month olds were prevaccine. There's also a chance that the theory (it's really the "scientific concensus", but I'm skeptical...long story...lol) that kids under two are unable form antibodies against the bacteria's polysaccharide, and that's why prevaccine most cases happened in kids under 2.

Looking at the evidence behind "the scientific concensus" might make for an interesting spinoff thread, relevant to the decisions selective/delayers are faced with.
mamakay is offline  
#21 of 100 Old 02-24-2009, 08:40 PM
 
anewmama's Avatar
 
Join Date: Feb 2007
Posts: 1,485
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
care to start that thread?! this is one that I am debating giving my daughter. She will be 2 in a month and a half.
anewmama is offline  
#22 of 100 Old 02-25-2009, 12:58 AM - Thread Starter
 
nycmom18's Avatar
 
Join Date: Dec 2008
Location: nyc
Posts: 852
Mentioned: 1 Post(s)
Tagged: 0 Thread(s)
Quoted: 2 Post(s)
i would love for this discussion to continue on this thread if you ladies are up to it. i haven't been commenting, just reading all of mamakay's posts

i must admit, all of the evidence and studies get confusing to me at times. can't research just simply state whether or not i should give my child this vaccine

of course not, i know, however, like anewmama, i'm seriously considering this vax. this is the only disease that i am truly worried about at this point. it gives me nightmares sometimes! yikes!

so to sum up the last couple of posts: if a child is given the hib vaccine or exposed to the bacteria prior to age 2, their immune system is not able to create adequate antibodies?

and i'm still confused how giving the vax or not to children affect their chance of getting hib later in life??

and does the vax then promote serotype replacement within the vaxed childs body, or is this serotype replacement happening on the population as a whole due to the vax?

*sigh* confusion....
nycmom18 is offline  
#23 of 100 Old 02-25-2009, 10:14 AM
 
Spectrolite's Avatar
 
Join Date: Feb 2009
Posts: 117
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
HiB study in Turkey (where HiB isnt in the vax schedule), says 65.3% of kids 6mo- 5 yrs have natural immunity.

--------
"Natural immunity to Haemophilus influenzae type B in children of Ankara, Turkey

Abstract Background : Haemophilus influenzae type b (Hib) infection has a high morbidity and mortality rate especially in children under 5 years of age. The incidence of Hib disease in Turkey is not known, and Hib vaccine is not included in the National Immunization Program. The aim of this study was to determine the natural immunity to Hib of children 6−60 months of age living in the Park Health Center region of Ankara, Turkey.

Methods : A total of 270 children were selected by layered random sampling method, and 242 of them (89.6%) participated in the study. A questionnaire was given to the parents of the children who were included in the study and blood samples were taken from those children. Anti-Hib IgG antibody (anti-PRP) level was determined in the serum by using anti-Haemophilus influenzae IgG EIA kit and anti-PRP antibody levels of 0.15 µg/mL and over were accepted as the natural immunity.

Results : Natural immunity was determined in 65.3% of the children. A relationship was determined statistically between the history of disease with possible Hib agent and with natural immunity.

Conclusions : The exposure rate of children with Hib was higher than expected, even in children who were just a few months old.
Our data revealed that multicentric, national studies should be done to define the burden of Hib disease before making a decision for Hib vaccine to be included in the National Immunization Program."
Spectrolite is offline  
#24 of 100 Old 02-25-2009, 11:15 AM
 
Spectrolite's Avatar
 
Join Date: Feb 2009
Posts: 117
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
but now i found this. am i reading this correctly? These are in 2 pre vaccine communities. are they saying that the younger children had low % (of naturally acquired) antibodies present, and the % decreased further still with age? ie barely any natural immunity at 4 years old?
this relates to anewmama's question on pg 1 of this thread.

"Natural Haemophilus influenzae type b capsular polysaccharide antibodies in 412 infants and children from West Africa (Burkina-Faso) and France: A cross-sectional serosurvey"

http://www.springerlink.com/content/q7747705540r2052/

None of the children from Burkina-Faso or France had antibody levels > 1.0 mgrg/ml before one year of age. Thereafter, only 9.51% of French children in the 12- to 17-month age stratum and 19.2% over 4 years of age had antibody levels > 1.0 mgrg/ml. There were no non-detectable results for children over 4 years of age, and the means for natural detectable Hib CP antibodies were > 0.15 mgrg/ml for both populations.
Spectrolite is offline  
#25 of 100 Old 02-25-2009, 12:07 PM
 
Spectrolite's Avatar
 
Join Date: Feb 2009
Posts: 117
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Dynamics of natural immunity caused by subclinical infections, case study on Haemophilus influenzae type b (Hib) (year 2000)


http://journals.cambridge.org/action...line&aid=66667

"Natural immunity to Haemophilus influenzae type b (Hib) is based primarily on antibodies that are thought to develop in response to subclinical infections. Wide use of conjugated Hib vaccines could lead to decreases in circulating Hib bacteria, thereby diminishing antibody levels in the unvaccinated. We applied a statistical model to estimate the duration of natural immunity to Hib under different forces of infection. Prior to the introduction of conjugated Hib vaccines, new Hib infections were estimated to occur once in 4 years and the antibody concentration to stabilize at a level around 1 μg/ml. In the absence of new stimuli, i.e. infection, 57% of the unvaccinated population would become susceptible to invasive disease (antibody levels < 0·15 μg/ml) in 10 years. Due to an interaction between the force of infection and the duration of immunity, in some situations numbers of invasive infections could increase in unvaccinated cohorts. This theoretical scenario has yet to be observed in practice."


So this doesn't sound good. :/

But I dont' quite understannd how breastfeeding comes into the picture then. Would the mother have had to acquired natural immunity at some point to be able to pass along the antibodies to her baby? So would this only happen most likely in non-vaccinated communities? I wasn't vaxed for this, I lived in the pre-vaccine era, possibly have natural immunity? Do i need to get my titers checked to see if I am passing along the right antibodies to dd?

Sorry I'm all over this thread these days. I am now sooo neck deep in this vax issue, it's been taking over every spare moment I have for the past 3 weeks. I feel like I NEED to decide very very soon on what to do. I talked with a organic food store owner today about vaxing (she doenst vax) and ended up getting rather teary. !! I just havne't really talked face to face about this issue with another "crunchy" mama who understands how emotions/mama instinct are part of this decision...
Spectrolite is offline  
#26 of 100 Old 02-25-2009, 12:41 PM
 
anewmama's Avatar
 
Join Date: Feb 2007
Posts: 1,485
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
All good questions. That last article you posted is what is giving me pause. And enough to make anyone a bit angry. If we are both reading it right, vaxing is doing to HiB like to what vaccination is doing to chickenpox. It is taking away the chances of later exposure and reinforcing immunity.

For breastfeeding.... I have seen the studies but never asked myself if they were done in areas where Hib vaccination uptake was high. If not, it would sort of make sense that breastfeeding confers immunity through antibodies until the child is older and then natural exposure comes into play and most kids are able to handle the exposure. Or, maybe breastfeeding provides protection and still Hi colonized early on so the colonization part happened and the antibodies are present already to help deal with it. So when breastfeeding is stopped, the body has some exposure. But what if you take away the natural circulation of Hi and the colonization doesn't happen, even where babies are breastfeed (and unvaccinated)? This is the point I am at.

So, breastfeeding would be great if HI were still circulating at higher rates. Without the circulation, how short term or long term is the breastfeeding protection? And without colonization, couldn't future exposure cause more problems?

And then at to this... serotype replacement?!

Enough to make you go a bit bonkers.
anewmama is offline  
#27 of 100 Old 02-25-2009, 01:21 PM
 
Spectrolite's Avatar
 
Join Date: Feb 2009
Posts: 117
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Yeah, anewmama, I guess I'm at the same point as your right now.

When I first delved into the complicated world of Hib, I found out about breastfeeding and thought, "ok, no problem, my babe will be fine." because I am exclusively breastfeeding and plan to for at least 6 months, and will continue to BF until she is 2.

I thought it was as simple as that.

But being that we live in a highly vaccinated community (and so far are only traveling in highly vaxed areas), we are not exposed to Hib. (Crazy thinking that now I would actually WANT to be exposed to this insane bacteria?! ???)



Also, I had only seen a handful of articles about BFing Hib protection. i don't know if they are enough for me

......Do we have to take a vacation to Turkey to get natural immunity for our kids? A MDC meet-up in sunny Ankara? I'm in!!

ps--with all this info, this "90% of us have the bacteria in our nose right now!" piece of info doesn't make sense ?? help?
Spectrolite is offline  
#28 of 100 Old 02-25-2009, 01:23 PM
 
Spectrolite's Avatar
 
Join Date: Feb 2009
Posts: 117
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
oh man, just read the turkish airlines crash story
Spectrolite is offline  
#29 of 100 Old 02-25-2009, 01:40 PM - Thread Starter
 
nycmom18's Avatar
 
Join Date: Dec 2008
Location: nyc
Posts: 852
Mentioned: 1 Post(s)
Tagged: 0 Thread(s)
Quoted: 2 Post(s)
sitting confused here as well:

i wonder if any study will realy ever get to the bottom of this. i mean, so many studies are done without all of the right components, therefore not being 100%truthful.

who knows anymore??....
nycmom18 is offline  
#30 of 100 Old 02-25-2009, 01:49 PM
 
Spectrolite's Avatar
 
Join Date: Feb 2009
Posts: 117
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
this is the kind of situation that makes me lean over to the vaxing side of the fence. I HATE the idea of vaxing, terrible terrible, pretty nasty, not so green thing. But if we opt out from it now, since it's gone so far already, are we still creating more risks for ourselves?
Spectrolite is offline  
Reply

User Tag List

Thread Tools
Show Printable Version Show Printable Version
Email this Page Email this Page


Forum Jump: 

Posting Rules  
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are On
Pingbacks are On
Refbacks are Off