Haemophilus influenzae Type b Vaccines: Lessons for the Future

PEDIATRICS ◽  
1988 ◽  
Vol 81 (6) ◽  
pp. 886-893
Author(s):  
JOEL I. WARD ◽  
CLAIRE V. BROOME ◽  
LEE H. HARRISON ◽  
HENRY SHINEFIELD ◽  
STEVEN BLACK
Keyword(s):  
Infectious Disease ◽  
Haemophilus Influenzae ◽  
Conjugate Vaccine ◽  
Alternative Interpretation ◽  
Polysaccharide Vaccine ◽  
Haemophilus Influenzae Type ◽  
Haemophilus Influenzae Type B ◽  
Type B ◽  
Safety And Efficacy ◽  
The Us

In recent months much controversy has focused on interpretations of new data concerning the safety and efficacy of Haemophilus influenzae type b vaccines.1-3 These controversies led the Infectious Disease Committee (Redbook Committee) of the Academy of Pediatrics (AAP) on Nov 13, 1987, to issue by telegram a change in recommendations for the H influenzae type b polysac-charide vaccine. Then, on Dec 22, 1987, the US Food and Drug Administration (FDA) licensed a new, more immunogenic, H influenzae type b conjugate vaccine (Prohibit-Connaught). The aim of this commentary is (1) to provide some background to these events, (2) to elucidate some of the difficulties involved in evaluating vaccines after licensure, (3) to present an alternative interpretation of available data regarding the polysaccharide vaccine, and (4) to comment on the new H influenza type b conjugate vaccine.

Safety and Efficacy of Haemophilus influenzae Type b Polysaccharide Vaccine

PEDIATRICS ◽  
1987 ◽  
Vol 80 (4) ◽  
pp. 590-592
Author(s):  
DAN M. GRANOFF ◽  
MICHAEL T. OSTERHOLM
Keyword(s):  
United States ◽  
Confidence Interval ◽  
Haemophilus Influenzae ◽  
The United States ◽  
Polysaccharide Vaccine ◽  
Haemophilus Influenzae Type ◽  
Haemophilus Influenzae Type B ◽  
Type B ◽  
Efficacy Trial ◽  
Safety And Efficacy

Haemophilus influenzae type b vaccine was licensed in the United States in the spring of 1985. Prior to licensure, extensive data had accumulated, indicating that this vaccine was safe and was immunogenic in children >18 to 23 months of age. Furthermore, in a large efficacy trial conducted in Finland, the vaccine also was found to be approximately 80% protective in preventing invasive type b Haemophilus disease in children 24 to 35 months of age (95% confidence interval 8, 95).1,2 Unfortunately, it was ineffective in children <18 months of age, the group most susceptible to Haemophilus disease, and it was of uncertain efficacy in those 18 to 23 months of age.

Safety, Tolerability, and Immunogenicity of Concurrent Administration of Haemophilus influenzae Type b Conjugate Vaccine (Meningococcal Protein Conjugate) With Either Measles-Mumps-Rubella Vaccine or Diphtheria-Tetanus-Pertussis and Oral Poliovirus Vaccines in 14-to 23-Month-Old Infants

PEDIATRICS ◽  
1990 ◽  
Vol 85 (4) ◽  
pp. 682-689 ◽  
Author(s):  
Barry Dashefsky ◽  
Ellen Wald ◽  
Nancy Guerra ◽  
Carol Byers
Keyword(s):  
Haemophilus Influenzae ◽  
Conjugate Vaccine ◽  
Capsular Polysaccharide ◽  
Age Groups ◽  
The United States ◽  
Polysaccharide Vaccine ◽  
Haemophilus Influenzae Type ◽  
Haemophilus Influenzae Type B ◽  
Type B ◽  
Concurrent Administration

In 1985, the first capsular polysaccharide (polyribosylribitol-phosphate [PRP]) vaccine for Haemophilus influenzae type b was licensed and recommended for routine use in children between 24 and 60 months of age.1,2 In the United States, approximately 75% to 90% of invasive disease due to H influenzae type b occurs in infants younger than 24 months,1,3 a population for whom H influenzae type b polysaccharide vaccine is inadequately immunogenic and protective. In an effort to enhance the immunogenicity of H influenzae type b polysaccharide vaccine for children in the most susceptible age groups, conjugate vaccines have been developed in which the capsular PRP of H influenzae type b has been bound to a variety of carrier proteins, thereby conferring the vaccines with thymic-dependent attributes.4,5 One such conjugate vaccine, in which the carrier protein is diphtheria toxoid (PRP-D), was licensed in 1987 and has been recommended since 1988 for routine use in children 18 months of age and older.6,7 A second conjugate vaccine, in which an oligosaccharide derivative of H influenzae type b capsular PRP is coupled to CRM197, a nontoxic mutant diphtheria toxin (oligo-CRM), was licensed in 1988 and is a sanctioned alternative to PRP-D.8 Another investigational conjugate vaccine, in which the polysaccharide is linked to the outer membrane protein of Neisseria meningitidis group B (PRP-OMPC), has been demonstrated to be both safe and immunogenic when administered in a two-dose schedule to 2- to 6-month-old infants.9 However, anti-PRP antibody levels decline significantly during the ensuing 10 to 15 months10,11; they rise significantly in response to booster doses of either PRP or PRP-OMPC administered 10 to 15 months after the initial priming doses of PRP-OMPC.11,12

scholarly journals Effectiveness of Haemophilus influenzae Type b Conjugate Vaccine Introduction Into Routine Childhood Immunization in Kenya

JAMA ◽  
2006 ◽  
Vol 296 (6) ◽  
pp. 671 ◽  
Author(s):  
Karen D. Cowgill ◽  
Moses Ndiritu ◽  
Joyce Nyiro ◽  
Mary P. E. Slack ◽  
Salome Chiphatsi ◽  
...  
Keyword(s):  
Haemophilus Influenzae ◽  
Conjugate Vaccine ◽  
Haemophilus Influenzae Type ◽  
Haemophilus Influenzae Type B ◽  
Type B ◽  
Childhood Immunization ◽  
Vaccine Introduction ◽  
Routine Childhood
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