The only way to reliably protect against Hib disease is immunisation. Antibodies to PRP (polyribosylribitol phosphate), a component of the polysaccharide cell capsule of Hib, are protective against invasive Hib disease. To induce a T-cell dependent immune response, the PRP polysaccharide has been linked (conjugated) to a variety of protein carriers. These conjugate Hib vaccines are immunogenic and effective in young infants (see also section 1.2.3). The protein carriers used are either an outer membrane protein of Neisseria meningitidis (PRP-OMP Hib vaccine), a mutant diphtheria toxin (Hb-OC Hib vaccine) or a tetanus toxoid (PRP-T Hib vaccine).
Note that the protein conjugates used in Hib vaccines are not themselves expected to be immunogenic and do not give protection against N. meningitidis, diphtheria or tetanus.
Hib-PRP-T (Hiberix, GSK) is also registered (approved for use) and is available (marketed) in New Zealand. It contains 10 µg of purified Hib capsular polysaccharide conjugated to 30 µg of inactivated tetanus toxoid. Other components (excipients) include lactose in the vaccine and sterile saline solution in the diluent.
The high efficacy and effectiveness of Hib vaccines have been clearly demonstrated by the virtual elimination of Hib disease in countries implementing the vaccine,3–5 including New Zealand. Hib vaccines are highly effective after a primary course of two or three doses.6–8 Disease following a full course of Hib vaccine is rare.
Conjugate vaccines reduce carriage in immunised children and as a result also decrease disease in unimmunised people (herd immunity). These vaccines will not protect against infection with NTHi strains of H. inﬂuenzae, and therefore do not prevent the great majority of otitis media, recurrent upper respiratory tract infections, sinusitis or bronchitis.
(See also section 14.4.2 for information about the DTaP-IPV-HepB/ Hib vaccine.)
A primary series followed by a booster dose in the second year of life should provide sufficient antibody levels to protect against invasive Hib disease to at least the age of 5 years.9
Transport according to the National Guidelines for Vaccine Storage and Distribution.10 Store at +2oC to +8oC. Do not freeze.
DTaP-IPV-HepB/Hib should be stored in the dark.
The dose of DTaP-IPV-HepB/Hib and Hib-PRP-T vaccines is 0.5 mL administered by intramuscular injection (see section 2.3).
DTaP-IPV-HepB/Hib and Hib-PRP-T vaccines can be co-administered with other routine vaccines on the Schedule, in separate syringes and at separate sites. (See also section 14.4.4 for information about co-administration of DTaP-IPV-HepB/Hib and PCV13.)