Haemophilus B
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Haemophilus influenzae type b (Hib)
stain of haemophilus B

Haemophilus influenzae bacteria can cause serious Hib disease among infants and children younger than 5 years. The disease is spread from person to person through respiratory droplets and direct contact with secretions. Hib bacteria normally enter through the nose and then multiply in the nose and throat. In some cases, the bacteria spread to the lungs or into the blood causing invasive diseases, such as bacterial meningitis, pneumonia, and other serious throat, skin, and bone infections.

Most people with invasive Hib disease need to be hospitalized and treated with antibiotics. Complications of Hib disease can include paralysis, deafness, blindness, mental retardation, and death. Healthcare personnel should report all cases of Hib disease to local and state health departments. Invasive Hib disease is rare in people older than 5 years, but there are some older children and adults who are also at risk.

Although influenza is part of its name, Haemophilus influenzae type b bacterium does NOT cause the flu. Influenza virus causes the flu.

About the Vaccine

Hib conjugate is an inactivated vaccine. It is made from linking the Hib bacteria's polysaccharide (sugar coating) to a protein. The current Hib vaccine that is available provides protection for children as young as 6 weeks old. The vaccine also offers varying amounts of protection to adult patients who have an increased risk of invasive Hib disease. Hib vaccine does not protect against meningitis that is caused by other bacteria and viruses.

There are several different brands of Hib vaccine. Some brands contain Hib vaccine combined with other vaccines. The number of doses needed depends on the brand of vaccine that is given. If you do not know the brand of Hib vaccine given to a child in the past or if the brand given in the past is not available, you may give any Hib vaccine brand.

Note: Children younger than 24 months who develop invasive Hib disease should not be considered immune to Hib disease. They should be given Hib vaccine as soon as they are well enough as recommended for their age.

Hib Vaccine Licensed for Use in the U.S.

Product: ActHIB® (Hib tetanus toxoid conjugate)
Manufacturer: Sanofi Pasteur
Year licensed: 1993 (in U.S.)
Product Insert

PedvaxHIB® (Hib meningococcal protein conjugate)
Manufacturer: Merck & Co
Year licensed: 1990
Product Insert

Hiberix® (Hib tetanus toxoid conjugate)
Manufacturer: GlaxoSmithKline
Year licensed: 2009
Product Insert Note: Only for use of Hib booster dose in children 15 months through 4 years of age.

Combination vaccines containing Hib vaccine licensed for Use in the U.S
Note: These vaccines are licensed only for use in children.

Product Name: Comvax® (Hib (meningococcal protein conjugate) and Hep B)
Manufacturer: Merck & Co
Year licensed: 1996
Product Insert

Product Name: Pentacel® (tetatus toxoid conjugate), DTaP, and IPV)
Manufacturer: Sanofi Pasteur
Year licensed: 2008
Product Insert

Product Name: MenHibrix (Hib and Neissera meningococcal serogroups C and Y)
Manufacturer: GlaxoSmithKline & Co
Year licensed: 2012
Product Insert

Indications Contraindications and precautions
Child
  • All infants and children 6 weeks to 5 years of age.
    Note: Children younger than 24 months who develop invasive Hib disease should not be considered immune to Hib disease. They should be given Hib vaccine as soon as they are well enough according to the schedule recommended for their age.
Older Children and Adults
  • Older children and adults who did not receive Hib vaccine in childhood and who have the following special health conditions:
    • splenectomy.
    • sickle cell disease.
    • bone marrow transplant.
    • HIV/AIDS.
    • cancer treated with drugs that suppress the immune system.
  • People who have had a severe allergic reaction to a previous dose of Hib vaccine or a Hib vaccine component.* If you are administering a Hib vaccine combined with other vaccines (DTaP, Hep B, and/or polio) also check for a history of severe allergic reaction to a previous dose of these vaccines.
  • People who are moderately or severely ill should wait until recovery before receiving any vaccine. Minor illnesses, such as a cold, are not a contraindication.
  • Infants younger than 6 weeks of age, because a dose given this early may make subsequent doses less effective.
Child
ActHIB Dose: 0.5 ml

Route: Intramuscular (IM) into mid-lateral aspect of thigh (infants and small children) or deltoid muscle of arm. During the course of primary immunizations, injections should not be made more than once at the same site.
Routine Administration Schedule:
  • Dose 1: 2 months
  • Dose 2: 4 months
  • Dose 3: 6 months
  • Booster Dose: 12-15 months
The recommended interval between doses 1-3 is 8 weeks, with a minimum interval of 4 weeks. At least 8 weeks should separate the booster from the previous dose.
Previously unvaccinated infants and children (catch-up):
  • 2-6 months old: Give three doses 2 months apart and final dose at 12-15 months old.*
  • 7-11 months old: Give two doses 2 months apart and final dose at 12-15 months old.*
  • 12-14 months old: Give initial dose and final dose 2 months later.
  • 15-59 months: Give one dose only with no booster dose.
*At least 2 months after previous dose.
PedvaxHib Dose: 0.5 ml

Route: Intramuscular (IM) into mid-lateral aspect of thigh of infants and small children or upper outer arm.
Routine Administration Schedule:
  • Dose 1: 2 months
  • Dose 2: 4 months
  • Booster Dose: 12-15 months
Previously unvaccinated infants and children (catch-up):
  • 2-11 months old: Give two doses 2 months apart and final dose at 12-15 months old.*
  • 12-14 months old: Give initial dose and final dose 2 months later.
  • 15-59 months: Give one dose only with no booster dose.
*At least 2 months after previous dose.
Hiberix Dose: 0.5 ml

Route: Intramuscular (IM) into mid-lateral aspect of thigh (small children) or deltoid muscle of arm.
Routine Administration Schedule:
  • Approved only for the booster dose of Hib in children 15 months through 4 years of age.
Pentacel (DTaP-IPV-Hib) Dose: 0.5 ml

Route: Intramuscular (IM) into mid-lateral aspect of thigh to infants and small children.
Routine Administration Schedule:
  • Dose 1: 2 months
  • Dose 2: 4 months
  • Dose 3: 6 months
  • Booster Dose: 12-15 months
The recommended interval between doses 1-3 is 8 weeks, with a minimum interval of 4 weeks. At least 8 weeks should separate the booster from the previous dose. Pentacel should NOT be used for the fifth dose of the DTaP series or for children 5 years or older.
Previously unvaccinated infants and children (catch-up):

The 3rd dose must be given on or after one year old at least two months after 2nd dose.
Comvax (Hib and Hep B) Dose: 0.5 ml

Route: Intramuscular (IM) into mid-lateral aspect of thigh to infants and small children.
Routine Administration Schedule:
  • 2, 4, 12-15 months of age
Previously unvaccinated infants and children (catch-up):

Not approved for children younger than 6 weeks of age or older than 15 months of age.

The third dose must be given at 12 months of age or older and at least 2 months after the second dose.

MenHibrix (Hib and Neissera meningococcal serogroups C and Y) Dose: 0.5 mL

Route: Intramuscular (IM) into mid-lateral aspect of thigh (infants and small children) or deltoid muscle of arm.
Routine Administration Schedule:
  • Dose 1: 2 months
  • Dose 2: 4 months
  • Dose 3: 6 months
  • Booster dose: 12-15 months

Adult
Most people older than 5 years of age do not need Hib vaccine. Some, however, are at risk at increased risk for invasive Hib disease and should discuss Hib vaccination with their health care providers. These people include:
  • People with sickle cell anemia
  • People who have a weak immune system. The immune system can be weakened by:
    • HIV/AIDS
    • long-term treatment with corticosteroid medication
    • cancer treatment with chemotherapy or radiation
    • bone marrow organ transplantation
    • asplenia (having no spleen)
A previously unvaccinated person with one of these conditions should get at least one dose of either ActHIB or PedvaxHIB.
Hib Side Effects*
  • Swelling, redness, or pain at the injection site, usually going away within a day, in 5% - 30% of recipients Infrequently, fever and irritability.
  • Severe allergic reaction (very rare)

Notes:
*When Hib antigens are given in combination with other antigens in one vaccine, the other antigens in the vaccine may cause other side effects. For more information about these possible side effects, go to the Polio,  Pertussis, Diphtheria, Tetanus, Hepatitis B, and Meningococcal pages.

Product Name Supplied Storage and Handling
ActHIB®
Sanofi Pasteur
Vial, 1 Dose, lyophilized vaccine (5 per package), packaged with 0.6 Ml vial containing saline diluent for reconstitution (5 per package) Store refrigerated between 2° to 8°C (36° to 46°F). Do not freeze. Discard if the vaccine has been frozen.

ActHIB® is a sterile, lyophilized powder in a single-dose vial that is reconstituted either with a saline diluent). Reconstitute using the saline diluent supplied by the manufacturer. Shake the vaccine vial thoroughly and withdraw 0.5 mL. Discard unused vaccine after 24 hours.
PedvaxHIB®
Merck & Co
Vial, 1 dose (10 per package) Store refrigerated between 2° and 8°C (36° and 46°F). Do not freeze. Discard if the vaccine has been frozen.

PedvaxHIB® is a slightly opaque white suspension. Shake the vial well and withdraw 0.5 mL. Thorough agitation is needed to maintain suspension of the vaccine.
Hiberix®
GlaxoSmithKline
Vial, 1 Dose, lyophilized vaccine (10 per package), packaged with a prefilled TIP-LOK syringe containing 0.7 mL of saline diluent for reconstitution (10 per package) Store refrigerated between 2° and 8°C (36° and 46°F). Do not freeze. Discard if the vaccine has been frozen. Protect vials from light.

Hiberix® is a sterile, lyophilized powder in a single-dose vial that is reconstituted using the saline diluent supplied by the manufacturer. Shake the vaccine vial thoroughly and withdraw 0.5 mL. The reconstituted vaccine should be clear and colorless. Discard unused vaccine after 24 hours.
Pentacel: A combination of Diphtheria and Tetanus Toxoids and Acellular Pertussis Adsorbed, Inactivated Poliovirus and Haemophilus b Conjugate (Sanofi Pasteur) vaccines Five vials of DTaP-IPV vaccine to be used as diluent, packaged with five 1 dose vials of lyophilized ActHIB vaccine Store refrigerated between 2° and 8°C (36° and 46°F). Do not freeze. Discard if the vaccine has been frozen.

Pentacel is a uniform, cloudy, white to off-white (yellow-tinge) suspension containing inactive DTaP, polio, and Hib antigens. Shake vials well before withdrawing dose. Reconstitute ActHIB with supplied DTaP-IPV vaccine only. Pentacel vaccine should be used immediately after reconstitution.
Comvax: A combination of Hepatitis B and Haemophilus b Conjugate (Sanofi Pasteur) vaccines 0.5 mL single-dose vials (10 per package) Store refrigerated between 2° and 8°C (36° and 46°F). Do not freeze. Discard if the vaccine has been frozen.

Comvax is a slightly opaque, white suspension containing inactive HIB and hepatitis B antigens. Shake well before administering. Look at consistency and coloring and discard if foreign particles are present.
Menhibrix: A combination of Haemophilus b Conjugate and meningococcal groups C and Y (GlaxoSmithKine) vaccines Vial, 1 dose of lyophilized vaccine (10 per package), packaged with 0.85 mL vials of saline diluent (10 per package) Store refrigerated between 2° and 8°C (36° and 46°F). Protect vaccine vials from light. Do not freeze. Discard if the vaccine has been frozen.

Administer immediately after reconstitution. 
12 Oct 05

Sample Q&A: The Vaccine

Who should get this vaccine?
All infants should receive Hib vaccine as part of their routine immunization (unless they have a medical reason not to). As Hib disease is rare in children older than five years, Hib vaccine is not routinely recommended for people five years or older.
Recommendations of the Advisory Committee on Immunization Practices (ACIP)
Package Insert - Vaccine
Comvax (Merck) 01 Dec 10
Package Insert - Vaccine
Package Insert - Vaccine
Package Insert - Vaccine
GlaxoSmithKline 24 Aug 09
Hiberix
Discontinuation of Tripedia and TriHiBit vaccines
Vaccine Information Statement (Interim)