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Prevention and Control of Haemophilus influenzae Type b Disease: Recommendations of the Advisory Committee on Immunization Practices (ACIP)

Having trouble viewing this email? View it as a Web page.   MMWR Recommendations and Reports Vol. 63, No. RR-1 February 28, 2014   PDF

Prevention and Control of Haemophilus influenzae Type b Disease: Recommendations of the Advisory Committee
on Immunization Practices (ACIP) 
Elizabeth C. Briere, MD, Lorry Rubin, MD, Pedro L. Moro, MD, et al.
MMWR 2014;63(No. RR-1) 

This report compiles and summarizes all recommendations from CDC’s Advisory Committee on Immunization Practices (ACIP) regarding prevention and control of Haemophilus influenzae type b (Hib) disease in the United States. As a comprehensive summary of previously published recommendations, this report does not contain any new recommendations; it is intended for use by clinicians, public health officials, vaccination providers, and immunization program personnel as a resource. This report updates information on Hib epidemiology in the United States and describes Hib vaccines licensed for use in the United States. Guidelines for antimicrobial chemoprophylaxis of contacts of persons with Hib disease also are provided.

Prevention and Control of Haemophilus influenzae Type b Disease: Recommendations of the Advisory Committee on Immunization Practices (ACIP)

Recommendations and Reports

February 28, 2014 / 63(RR01);1-14

Prepared by

Elizabeth C. Briere, MD1

Lorry Rubin, MD2

Pedro L. Moro, MD3

Amanda Cohn, MD1

Thomas Clark, MD1

Nancy Messonnier, MD1

1Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, CDC

2 Steven and Alexandra Cohen Children's Medical Center of New York, New Hyde Park, New York

3Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, CDC

Corresponding preparer: Elizabeth C. Briere, MD, National Center for Immunization and Respiratory Diseases, CDC, 1600 Clifton Road NE, MS C-09, Atlanta, GA 30333. E-mail: ebriere@cdc.gov.

Summary

This report compiles and summarizes all recommendations from CDC's Advisory Committee on Immunization Practices (ACIP) regarding prevention and control ofHaemophilus influenzae type b (Hib) disease in the United States. As a comprehensive summary of previously published recommendations, this report does not contain any new recommendations; it is intended for use by clinicians, public health officials, vaccination providers, and immunization program personnel as a resource. ACIP recommends routine vaccination with a licensed conjugate Hib vaccine for infants aged 2 through 6 months (2 or 3 doses, depending on vaccine product) with a booster dose at age 12 through 15 months. ACIP also recommends vaccination for certain persons at increased risk for Hib disease (i.e., persons who have early component complement deficiencies, immunoglobulin deficiency, anatomic or functional asplenia, or HIV infection; recipients of hematopoietic stem cell transplant; and recipients of chemotherapy or radiation therapy for malignant neoplasms). This report summarizes current information on Hib epidemiology in the United States and describes Hib vaccines licensed for use in the United States. Guidelines for antimicrobial chemoprophylaxis of contacts of persons with Hib disease also are provided.

Introduction

Before 1985, Haemophilus influenzae type b (Hib) was the leading cause of bacterial meningitis and a common cause of other invasive diseases (e.g., epiglottitis, pneumonia, septic arthritis, cellulitis, purulent pericarditis, and bacteremia) among U.S. children aged <5 years (1). Meningitis occurred in approximately two thirds of children with invasive Hib disease; 15%–30% of survivors had hearing impairment or severe permanent neurologic sequelae. Approximately 4% of all cases were fatal (2). The first polysaccharide Hib vaccine was introduced in the United States in 1985, followed by conjugate Hib vaccines in 1987 and 1989. During 1989–2000, the annual incidence of invasive Hib disease in children aged <5 years decreased by 99%, to less than one case per 100,000 children (3–7). During 2000–2012, the average annual incidence rate of invasive Hib disease in children aged <5 years in the United States remained below the Healthy People 2020 goal of 0.27/100,000 (8) (data available at http://www.cdc.gov/abcs/reports-findings/surv-reports.html) (Figures 1 and 2). Studies have demonstrated that vaccination with Hib conjugate vaccine leads to decreases in oropharyngeal colonization among both vaccinated and unvaccinated children (9–11); the prevalence of Hib carriage has decreased among preschool-aged children from 2%–7% in the prevaccine era to <1% in the vaccine era (9,12).

Several Hib-containing vaccines have been licensed since the initial Advisory Committee on Immunization Practices (ACIP) recommendations on prevention and control of Hib disease published in 1993 (13 ); subsequent publications have provided additional data and updated recommendations for these vaccines (14–17). This report summarizes previously published ACIP recommendations on prevention and control of Hib disease in immunocompetent and high-risk populations (14–18); it does not contain new recommendations and is intended as a resource for clinicians, public health officials, vaccination providers, and immunization program personnel. In addition, this report summarizes current information on Hib epidemiology in the United States and describes Hib vaccines licensed for use in the United States. Guidelines for antimicrobial chemoprophylaxis of contacts of persons with Hib disease also are provided.