Haemophilus influenzae type b (Hib) vaccines help prevent Haemophilus infections Haemophilus Infections The gram-negative bacteria Haemophilus species cause numerous mild and serious infections, including bacteremia, meningitis, pneumonia, sinusitis, otitis media, cellulitis, and epiglottitis... read more but not infections caused by other strains of H. influenzae bacteria. H. influenzae causes many childhood infections, including bacteremia Bacteremia Bacteremia is the presence of bacteria in the bloodstream. It can occur spontaneously, during certain tissue infections, with use of indwelling genitourinary or IV catheters, or after dental... read more , meningitis Acute Bacterial Meningitis Acute bacterial meningitis is rapidly progressive bacterial infection of the meninges and subarachnoid space. Findings typically include headache, fever, and nuchal rigidity. Diagnosis is by... read more , pneumonia Overview of Pneumonia Pneumonia is acute inflammation of the lungs caused by infection. Initial diagnosis is usually based on chest x-ray and clinical findings. Causes, symptoms, treatment, preventive measures, and... read more , sinusitis Sinusitis Sinusitis is inflammation of the paranasal sinuses due to viral, bacterial, or fungal infections or allergic reactions. Symptoms include nasal obstruction and congestion, purulent rhinorrhea... read more , otitis media Otitis Media (Acute) Acute otitis media is a bacterial or viral infection of the middle ear, usually accompanying an upper respiratory infection. Symptoms include otalgia, often with systemic symptoms (eg, fever... read more , and epiglottitis Epiglottitis Epiglottitis is a rapidly progressive bacterial infection of the epiglottis and surrounding tissues that may lead to sudden respiratory obstruction and death. Symptoms include severe sore throat... read more .
For more information, see Hib Advisory Committee on Immunization Practices Vaccine Recommendations and Centers for Disease Control and Prevention (CDC): Hib Vaccination. A summary of changes to the 2022 adult immunization schedule is available here.
(See also Overview of Immunization Overview of Immunization Immunity can be achieved Actively by using antigens (eg, vaccines, toxoids) Passively by using antibodies (eg, immune globulins, antitoxins) A toxoid is a bacterial toxin that has been modified... read more .)
Preparations of Hib Vaccine
Hib vaccines are prepared from the purified capsule of Haemophilus influenzae type b (Hib). All Hib vaccines use polyribosylribitol phosphate (PRP) as the polysaccharide, but 4 different protein carriers are used in the 4 different Hib conjugate vaccines available:
Diphtheria toxoid (PRP-D)
Neisseria meningitidis outer membrane protein (PRP-OMP)
Tetanus toxoid (PRP-T)
Diphtheria mutant carrier protein CRM197 (HbOC)
PRP-D and HbOC vaccines are no longer available in the US.
Combination vaccines that contain Hib conjugate vaccines include DTaP Diphtheria-Tetanus-Pertussis Vaccine Vaccines that contain diphtheria toxoid, tetanus toxoid, and acellular pertussis help protect against diphtheria, tetanus, and pertussis, but they do not prevent all cases. For more information... read more - IPV Poliomyelitis Vaccine Extensive vaccination has almost eradicated polio worldwide. But cases still occur in areas with incomplete immunization, such as sub-Saharan Africa and southern Asia. There are 3 serotypes... read more /Hib (combination vaccines are indicated for children 6 weeks to < 5 years of age).
Indications for Hib Vaccine
The Hib vaccine is a routine childhood vaccination ( see Table: Recommended Immunization Schedule for Ages 0–6 Years Recommended Immunization Schedule for Ages 0–6 Years ).
This vaccine is also recommended for
Adults with anatomic or functional asplenia Asplenia By structure and function, the spleen is essentially 2 organs: The white pulp, consisting of periarterial lymphatic sheaths and germinal centers, acts as an immune organ. The red pulp, consisting... read more and those scheduled for elective splenectomy if they are unimmunized (ie, if they have not previously received a primary series plus booster dose or ≥ 1 dose of Hib vaccine after age 14 months), although some experts suggest giving a dose before elective splenectomy regardless of vaccination history
Immunocompromised adults (eg, because of cancer chemotherapy or HIV infection) if they are unimmunized
People who have had a hematopoietic stem cell transplantation Hematopoietic Stem Cell Transplantation Hematopoietic stem cell (HSC) transplantation is a rapidly evolving technique that offers a potential cure for hematologic cancers ( leukemias, lymphomas, myeloma) and other hematologic disorders... read more regardless of their vaccination history
Contraindications and Precautions of Hib Vaccine
The main contraindication for Hib vaccines is
A severe allergic reaction (eg, anaphylaxis Anaphylaxis Anaphylaxis is an acute, potentially life-threatening, IgE-mediated allergic reaction that occurs in previously sensitized people when they are reexposed to the sensitizing antigen. Symptoms... read more ) after previous dose or to a vaccine component
The main precaution with Hib vaccines is
Moderate or severe illness with or without a fever (vaccination is postponed until the illness resolves)
Dose and Administration of Hib Vaccine
The Hib vaccine dose is 0.5 mL IM. A primary childhood series is given in 3 doses at age 2, 4, and 6 months or in 2 doses at age 2 and 4 months, depending on the formulation. In either case, a booster is recommended at age 12 to 15 months.
One dose is given to older children, adolescents, and adults who have asplenia or who are scheduled for an elective splenectomy if they are unimmunized. Some experts suggest giving a dose before elective splenectomy regardless of vaccination history. The dose is given ≥ 14 days before elective splenectomy if possible.
A 3-dose regimen is given 6 to 12 months after hematopoietic stem cell transplantation; doses are separated by ≥ 4 weeks.
Adverse Effects of Hib Vaccine
Adverse effects are rare. They can include pain, redness, and swelling at the injection site and, in children, fever, crying, and irritability.
The following English-language resources may be useful. Please note that THE MANUAL is not responsible for the content of these resources.
Advisory Committee on Immunization Practices (ACIP): Hib ACIP Vaccine Recommendations
Centers for Disease Control and Prevention (CDC): Hib Vaccination: Information for Healthcare Professionals
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