Who is at Highest Risk for Complications from Hib Vaccine?
Persons at highest risk for complications from Hib vaccine are those listed below who are advised not to get Hib vaccine.
Who Should Not Get Hib Vaccine?
According to the CDC anyone who has ever had a life-threatening allergic reaction to a previous dose of Hib vaccine should not get another dose. Children under 6 weeks old should not get this vaccine either. Also, people who are moderately or severely ill at the time the shot is scheduled should wait until they recover before getting this vaccine.1
In general, vaccination of children older than 59 months is not recommended, mainly because by that age the majority of children have acquired natural immunity to it. However, the CDC says that some older children and adults who are at increased risk of getting the disease may be vaccinated. Those persons include those with functional or anatomic asplenia such as sickle cell disease, immunodeficiency, immunosuppression from cancer chemotherapy, infection with HIV, and those who have received a hematopoietic stem cell transplant.2
Also, according to the manufacturer’s product inserts:
- ActHIB should not be given to children with a history or hypersensitivity to any component of the vaccine and to any component of DTP or Tripedia vaccine when combined by reconstitution with these vaccines. Any contraindication to DTP and/or Tripedia is a contraindication for receiving ActHib reconstituted with Tripedia. Also, ActHIB should not be given to infants younger than 15 months old.3
- Hiberix should not be used as a primary vaccination. Anyone who has suffered severe allergic reactions or anaphylaxis after a previous dose of any Hib vaccine or tetanus-toxoid-containing vaccine or any component of Hiberix should not get this vaccine. If Guillain-Barre syndrome has occurred within six weeks of receipt of a prior vaccine containing tetanus toxoid, the decision to give Hiberix should be based on careful consideration of the potential benefits vs. possible risks.4
- PedvaxHib should not be given to anyone with a hypersensitivity to any component of the vaccine or the diluent. Persons who develop symptoms suggestive of hypersensitivity after an injection should not receive further injections of the vaccine. Use caution with children allergic to latex as the vial stopper contains dry natural latex rubber. The decision to administer or delay vaccination because of current or recent febrile illness depends on the severity of symptoms and etiology of the disease. Persons with moderate or severe febrile illness should be vaccinated after they have recovered. Persons over age 6 years or infants under 6 weeks of age should not get PedvaxHib. This vaccine is NOT recommended for use in adult populations.5
- Comvax should not be given to any infant before the age of 6 weeks. Comvax is not recommended for use in women of childbearing age because it is not known whether Comvax can cause fetal harm when administered to pregnant women. This vaccine is NOT recommended for use in adult populations. Deferral of vaccination with Comvax may be considered in individuals receiving immunosuppressive therapy. Comvax should be given with caution in infants with bleeding disorders such as hemophilia or thrombocytopenia, with steps taken to avoid the risk of hematoma following the injection.6
- Pentacel should not be given to anyone who has suffered severe allergic reactions (anaphylaxis) after a previous dose of this vaccine, any ingredient of Pentacel vaccine, or any other diphtheria toxoid, tetanus toxoid, pertussis-containing vaccine, inactivated poliovirus vaccine or Hib vaccine. Pentacel should not be given to anyone who has suffered encephalopathy within seven days of a previous pertussis-containing vaccine with no other identifiable cause. Persons with a progressive neurologic disorder should not receive Pentacel until a treatment regimen has been established and the condition has stabilized. Careful consideration should be given to the benefits vs. risks before administering Pentacel to someone with a history of fever at or above 105 degrees F, a hypotonic-hyporesponsive episode, or persistent, inconsolable crying lasting more than three hours within 48 hours after a pertussis-containing vaccine, or who has suffered seizures within three days after a previous pertiussis-containing vaccine. If Guillain-Barre syndrome occurred within six weeks of receipt of a prior vaccine containing tetanus toxoid, the risk for Guillain-Barre syndrome may be increased following Pentacel.7
- MenHibrix should not be given to any child that has suffered Guillain-Barre syndrome within 6 weeks of receipt of a prior vaccine containing tetanus toxoid. The decision to administer it should be based on careful consideration of the possible benefits and risks of the vaccine. Careful consideration should also be given as to whether to give this vaccine to premature infants, since apnea following the injection in premature infants has occurred. Any child that has had a severe allergic reaction (anaphylaxis) to a previous dose of any meningococcal, Hib or tetanus-toxoid-containing vaccine or any component of MenHibrix should not receive this vaccine. It is not known whether MenHibrix can cause fetal harm when administered to a pregnant woman, or if it can affect reproduction capacity. Safety and effectiveness of MenHibrix in children younger than 6 weeks of age and children 19 months to 16 years old have not been established.8
IMPORTANT NOTE: NVIC encourages you to become fully informed about Haemophilus Influenza Type B (Hib) and the Hib vaccine by reading all sections in the Table of Contents, which contain many links and resources such as the manufacturer product information inserts, and to speak with one or more trusted health care professionals before making a vaccination decision for yourself or your child. This information is for educational purposes only and is not intended as medical advice.
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1FDA.gov. Haemophilus b Conjugate Vaccine Manufacturer’s Product Insert. Sanofi Pasteur. May 6, 2009. Online. (Accessed June 2012)
2CDC.gov. Who Should NOT Get Vaccinated with These Vaccines? Hib Vaccine. Feb. 27, 2012. Online.(Accessed May 2012)
3CDC.gov. Haemophilus Influenzae Type B. The Pink Book. No Date. Online.(Accessed June 2012)
4FDA.gov. Haemophilus b Conjugate Vaccine ActHIB Manufacturer’s Product Insert. Sanofi Pasteur. May 6, 2009. Online. (Accessed June 2012)
5FDA.gov. Haemophilus b Conjugate Vaccine (Tetanus Toxoid Conjugate) Hiberix Manufacturer’s Product Insert. GlaxoSmithKline. Dec 2010. Online.(Accessed June 2012)
6FDA.gov. Haemophilus b Conjugate Vaccine (Meningococcal Protein Conjugate) Liquid PedvaxHIB Manufacturer’s Product Insert. Merck & Co. 1998. Online.(Accessed June 2012)
7FDA.gov. Haemophilus b Conjugate (Meningococcal Protein Conjugate) and Hepatitis B (Recombinant) Vaccine Comvax. Merck & Co. 2001. Online.(Accessed June 2012)
8FDA.gov. Diphtheria and Tetanus Toxids and Acellular Pertussis Adsorbed, Inactivated Poliovirus and Haemophilus b Conjuage (Tetanus Toxoid Conjugate) Pentacel Manufacturer’s Product Insert. Sanofi Pasteur. July 2011. Online.(Accessed June 2012)