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. 2006 Jun;12(6):937-41.
doi: 10.3201/eid1206.051451.

Haemophilus influenzae type b reemergence after combination immunization

Nik G Johnson  1 , Jens U Ruggeberg, Gail F Balfour, Y Chen Lee, Helen Liddy, Diane Irving, Joanna Sheldon, Mary P E Slack, Andrew J Pollard, Paul T Heath
Affiliations

Haemophilus influenzae type b reemergence after combination immunization

Nik G Johnson et al. Emerg Infect Dis. 2006 Jun.

Abstract

An increase in Haemophilus influenzae type b (Hib) in British children has been linked to the widespread use of a diphtheria/tetanus/acellular pertussis combination vaccine (DTaP-Hib). We measured anti-polyribosyl-ribitol phosphate antibody concentration and avidity before and after a Hib booster in 176 children 2-4 years of age who had received 3 doses of DTP-Hib (either DT whole cell pertussis-Hib or DTaP-Hib) combination vaccine in infancy. We also measured pharyngeal carriage of Hib. Antibody concentrations before and avidity indices after vaccination were low (geometric mean concentration 0.46 mug/mL, 95% confidence interval [CI] 0.36-0.58; geometric mean avidity index 0.16, 95% CI 0.14-0.18) and inversely related to the number of previous doses of DTaP-Hib (p = 0.02 and p<0.001, respectively). Hib was found in 2.1% (95% CI 0.7%-6.0%) of study participants. Our data support an association between DTaP-Hib vaccine combinations and clinical Hib disease through an effect on antibody concentration and avidity.

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Figures

Figure 1
Figure 1
Geometric mean anti-polyribosyl-ribitol phosphate antibody concentration before booster (95% confidence intervals) in 2- to 4-year-old children, according to number of doses of acellular pertussis (aP) containing Haemophilus influenzae type b combination vaccines received in infancy. Number of participants is shown in parentheses. GMC, geometric mean concentration.
Figure 2
Figure 2
Anti-polyribosyl-ribitol phosphate antibody concentrations in 2- to 4-year-old children, according to number of doses of acellular pertussis containing Haemophilus influenzae type b combination vaccines received in infancy. Proportion achieving different concentrations is shown.
Figure 3
Figure 3
Geometric mean avidity index (GMAI) (95% confidence intervals [CI]) after booster in 2- to 4-year-old children, according to number of doses of acellular pertussis containing Haemophilus influenzae type b combination vaccines received in infancy. Number of participants is shown in parentheses.
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