Prather Pediatric and Allergy Center - Ask Doctor Brent

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Title: New Pediatric Vaccine Recommendations

Category: Child Care


At the recent American Academy of Pediatrics annual convention in Boston, a new recommendation for the Hib vaccine was made. This is a vaccine made from the cell wall of the Haemophilus b bacteria and it prevents childhood meningitis.

Through several studies over the past few years it was found that this vaccine worked as early as 2 months and so the recommendation is now changed to give it at 2, 4 and 6 months and then a booster at 15 months. This is different from the previous recommendation which was to give a single dose at 15 months. The reason the AAP is now recommending giving it early is because most childhood meningitis does occur in the first year and a half. By protecting these younger babies, it is felt that meningitis may be almost wiped out in the near future.

The Haemophilus bacteria causes about 95 % of childhood spinal meningitis but it also causes pneumonia, epiglottides and joint infections. This new recommendation from the AAP as well as the Food and Drug Administration was approved for a single type of Hib vaccine called the HibOC vaccine or the Hib titer vaccine. It is felt that the recommendation will come out soon for a few other competitor vaccines. The HibOC is made by the Lederle-Praxis Laboratories. Clinical trials of the vaccine in over 60,000 infants have shown very good effectiveness of the vaccine with only very mild side effects. No serious vaccine side effects have been noted. The main side effects are soreness in the arm and low grade fever. Should the patient be between the ages of 2 months and 15 months, then specific recommendations are given. If the patient comes in before six months, then ideally three vaccines in a row at two month intervals are given and then a final booster at 15 months. If the patient comes in between 7 and 11 months then 2 doses are given and then a third (booster) at 15 months. And if the patient comes in between 12 and 14 months, then a single dose is given followed by a booster at 15 months. If the patient does not come in prior to 15 months then a single dose should be given at 15 months. This also should be done if the patient comes in after 15 months all the way up to 60 months. After age five, the risk of H-flu meningitis is much less, and so the present recommendation is to not give the vaccine after 60 months. However, it can be given at the parents request. Any of the currently licensed conjugate vaccines can be given at 15 months or after. The CDC also agrees with the FDA recommendation and was involved in the study done with the Northern California Kaiser Permanente Health Plan. In that study, half of the children received vaccine and half received placebo, totalling 60,000 infants. Twelve cases of the Haemophilus invasive disease occurred in the unvaccinated children and there were no cases in the fully vaccinated children. This indicated a 100% efficacy of the vaccine in that particular trial. This led to the FDA recommendation which came out last week and is a major change in the recommendation for this vaccine. Hopefully the United States will supply the money so that all infants throughout the country will be able to receive the vaccines at an early age and we can wipe out the dread disease of meningitis in the very near future.