Contents

6 Haemophilus influenzae type b (Hib) disease

6.5 Recommended immunisation schedule

6.5.1 Usual childhood schedule

Hib vaccine is funded for all children aged under 5 years. A primary course of Hib-PRP-T as DTaP-IPV-HepB/Hib (Infanrix-hexa) vaccine is given at ages 6 weeks, 3 months and 5 months, and a booster of Hib-PRP-T (Act-HIB) is given at age 15 months.

For children aged under 5 years who, for whatever reason, have missed out on Hib vaccine in infancy, a catch-up schedule is recommended. The total number of doses of Hib vaccine required is determined by the age at which Hib immunisation commences. Where possible, the combined available vaccines should be used, but individual immunisation schedules based on the recommended national schedule may be required for children who have missed some immunisations (see Appendix 2).

6.5.2 Special groupsTop

Children

Because of an increased risk of infection, it is particularly important that the following groups of children, whatever their age, receive the Hib vaccine as early as possible (see also sections 4.2 and 4.3):

Recommendations for Hib vaccine for older children and adults with asplenia

Although there is no strong evidence of an increased risk of invasive Hib disease in asplenic older children and adults, many authorities recommend Hib immunisation for these individuals. The Hib PRP-T vaccine has been shown to be immunogenic in adults.

Hib-PRP-T vaccine (Act-HIB) is funded for older children and adults pre- or post-splenectomy or with functional asplenia; one dose of vaccine is recommended (see also section 4.3.4). Hib-PRP-T vaccine is approved for use (registered) in individuals aged under 5 years; use of Hib-PRP-T vaccine in children older than 5 years and adults will be outside current licensure, and parents/guardians and individuals must be fully informed of this. There are not expected to be any safety concerns for use in older age groups.

(Pneumococcal, meningococcal, influenza, varicella and pertussis-containing vaccines are also recommended for these individuals; see section 4.3.4 and the relevant disease chapters.)

6.5.3 Children who have recovered from invasive Hib diseaseTop

Children aged under 2 years with Hib disease do not reliably produce protective antibodies and need to receive a complete course of Hib vaccine. The number of doses required will depend on the age at which the first dose after the illness is given, ignoring any doses given before the illness (follow the age-appropriate catch-up schedules in Appendix 2).

Commence immunisation approximately four weeks after the onset of disease.

Any immunised child who develops Hib disease or who experiences recurrent episodes of Hib invasive disease requires immunological investigation by a paediatrician.

6.5.4 (Re-)vaccinationTop

Hib-containing vaccines are funded for (re-)vaccination of eligible patients, as follows.

DTaP-IPV-HepB/Hib (Infanrix-hexa) is funded for children aged under 10 years:

Hib-PRP-T (Act-HIB) is funded for patients:

See also sections 4.2 and 4.3.