Hiberix: Haemophilus Influenza Type B Vaccine

Articles / September 27, 2016

Hiberix is a non-infectious vaccine used to prevent Haemophilus influenza type B (Hib) infection in children aged 2 months to 5 years. Hiberix is indicated for active immunization, meaning that it causes the body to produce its own antibodies against the disease.

Haemophilus influenzae is a gram-negative, rod-shaped bacterium responsible for bacterial influenza. Most strains of the bacterium are opportunistic pathogens, meaning that they live in their host without causing disease, but cause problems only when other factors (such as viral infection, reduced immune function or chronically inflamed tissues, e.g. from allergies) create an opportunity.

Naturally-acquired disease caused by H. influenzae seems to occur in humans only. In infants and young children, H. influenza causes bacteremia, pneumonia, and acute bacterial meningitis. On occasion, it causes cellulitis, osteomyelitis, epiglottitis, and infectious arthritis.

Clinical diagnosis of H. influenzae is typically performed by bacterial culture or latex particle agglutinations. Diagnosis is considered confirmed when the organism is isolated from a sterile body site. In this respect, H. influenzae cultured from the nasopharyngeal cavity or sputum would not indicate H. influenzae disease, because these sites are colonized in disease-free individuals. However, H. influenzae isolated from cerebrospinal fluid or blood would indicate H. influenzae infection.

H. influenzae produces beta-lactamases, and it is also able to modify its penicillin-binding proteins, so it has gained resistance to the penicillin family of antibiotics. In severe cases, cefotaxime and ceftriaxone delivered directly into the bloodstream are the elected antibiotics, and, for the less severe cases, an association of ampicillin and sulbactam, cephalosporins of the second and third generation, or fluoroquinolones are preferred (fluoroquinolone-resistant H. influenzae has been observed).Macrolide antibiotics (e.g. clarithromycin) may be used in patients with a history of allergy to beta-lactam antibiotics (macrolide resistance has also been observed).

Effective vaccines for H. influenzae have been available since the early 1990s, so it is preventable. The World Health Organization recommends a pentavalent vaccine, combining vaccines against diphtheria, tetanus, pertussis, hepatitis B and Hib. There is not yet sufficient evidence on how effective this pentavalent vaccine is in relation to the individual vaccines.H. influenzae vaccines cost about seven times the total cost of vaccines against measles, polio, tuberculosis, diphtheria, tetanus, and pertussis. Consequently, whereas 92% of the populations of developed countries were vaccinated against H. influenzae as of 2003, vaccination coverage was 42% for developing countries, and only 8% for least-developed countries.

Hiberix is a single intramuscular injection (approximately 0.5 ml) after reconstitution, and it is to be injected into the anterolateral aspect of the thigh or deltoid. It is not intended for intradermal, intravenous or subcutaneous administration. The vaccine is generally given as a total of three doses over 6 months. The first dose should be given at 2 months of age, and the remaining two doses at 4 and 6 months respectively.

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