haemophilus influenzae type b
DESCRIPTION
Hib vaccine for younger children – booster campaign 2007 to 2009 Adapted, with permission, for use in Scotland from materials produced by the Department of Health http://www.immunisation.nhs.uk/files/hib_presentation_handouts.pdf. Haemophilus influenzae type b. - PowerPoint PPT PresentationTRANSCRIPT
Hib vaccine for younger children – booster campaign
2007 to 2009Adapted, with permission, for use in Scotland from materials produced by the Department of Healthhttp://www.immunisation.nhs.uk/files/hib_presentation_handouts.pdf .
Haemophilus influenzae type b • Bacterial infection of young children• 60% of invasive cases have meningitis +/- bacteraemia
– 5% case fatality rate– 15-30% neurological complications
• 10% septicaemia• Pneumonia, septic arthritis, osteomyelitis, pericarditis,
cellullitis, epiglotitis
Immunisation & epidemiology
• 1992: Hib vaccine introduced → dramatic fall in cases
• 1999 start of low level increase in cases → need for booster campaign
• 2003: booster campaign for children 6 months to 4 years
• September 2006: Introduction of routine booster at 12 months (Hib/MenC)
Cohort being targeted
• Children born 4 April 2003 to 3 September 2005
• Children born on or after 4 April 2003 – as they are too young to have had a booster in the 2003 booster campaign
• Children born on or before 3 September 2005- as they are too old to have received the new Hib/MenC booster at 12 months
Rationale
• Children being targeted will have lower levels of Hib immunity
• Their risk is greater in relative terms than older or younger children who have received a booster
• Absolute risk for this cohort is 30 cases across UK
• JCVI recommendation
JCVI Feb 2007
• Reviewed incidence of Hib disease in 3-4 year olds and older
• More than expected
• Fall in children targeted in 2003 booster campaign
• But no strong herd effect
Summary of campaign• Starts 5 November 2007; ends 3 March 2009
• For most of the cohort, PSB vaccine will change to product containing Hib
• Children who have already had PSB – recall for Hib/MenC
• Bring forward timing of routine PSB to 3 years after primary course completed
Rationale for schedule
• Adding Hib to PSB avoids extra injections & ensures higher coverage
• All children should be offered PSB at age recommended in Green Book because:– It’s best practice– Otherwise youngest children in cohort
wouldn’t receive Hib booster until 2010– The only alternative to delay would be a
separate catch-up campaign
A locally phased campaign
• Lowering the age for PSB will be phased in – By local agreement as there is variation in
the age at which PSB is currently given
• Temporary increase in clinic capacity will be needed
Routine
• By the end of the campaign it will become routine to call children for PSB at 3 yrs 4 months – 3yrs 6 months
• Children who finish primary imms late should have PSB a min of 1 year later
Vaccines to be used:
• Hib/MenC for children who have already received PSB
• Infanrix-IPV+Hib for the main body of children due their PSB
• Pediacel if absolutely necessary
Use of Infanrix-IPV+Hib
• Use of Infanrix-IPV+Hib strongly recommended to conserve stocks of Pediacel for primary immunisation
• Infanrix-IPV+Hib should not be used for primary immunisation as it has 3 component aP and doesn’t offer the same protection as the 5 component aP in Pediacel
Re “off-label” use:
• Infanrix-IPV+Hib SPC states upper age of 36 months
• Expert review by JCVI takes precedence
• NB Pediacel is frequently used off-label
Infanrix-IPV+Hib
• Single dose pack
• Pre-filled syringe and vial contained Hib portion as powder
• Green + blue needles included
Vaccine supply issues
• Infanrix-IPV+Hib, Menitorix & Pediacel should be ordered in the usual way
• Local stocks of Repevax and Infanrix IPV should be depleted by 5 November launch
Adverse reactions
• aP vaccines less reactogenic than wP, but, booster doses of aP after priming with aP, associated with an increase in local reactions
• Reaction usually develop within 24 hours and settle within 5 days – can be mistaken for cellulitis
• More of a problem with 5th dose than 4th
• Increased local reaction expected with any aP booster
• First children primed with aP due for PSB in late 2007
Resources
• PGDs – will be updated locally
• Leaflets for parents and a Q&A factsheet
• Updated Health Scotland websitewww.healthscotland.com/immunisation/
Children in cohort who may have already had a dose of Hib-containing vaccine over the age of 12 months
• See Green Book page 132– “…one dose of Hib is effective from one
year of age…”
– Therefore no further Hib booster required