A randomized, prospective field trial of a conjugate vaccine in the protection of infants and young children against invasive Haemophilus influenzae type b disease

Article Abstract:

Haemophilus influenzae type b is a bacteria that can cause serious illnesses, such as meningitis and pneumonia, and death in children. Up to 85 percent of the 20,000 children who contract this infection each year in the United States are under five years of age. A vaccine which recognizes specific sugars on the bacterial coat has been developed, but it is not very effective against the bacteria in children under 18 months of age, which is the population at greatest risk. A new vaccine which is produced against a carbohydrate-protein viral extract coupled to diphtheria toxin has been shown to be more effective in protecting children of this age. A group of 114,000 infants was included in an evaluation of this vaccine in Finland. Half the children were given this vaccine starting at 3 months (with additional shots at 4, 6, and 14 to 18 months) while a similar sized group of children did not receive the vaccine until after two years of age. Only four proven cases of Haemophilus influenzae were found in children receiving the vaccine at an early age when they had been inoculated at least three times (at 3, 4 and 6 months). The unvaccinated group had an infection rate of 64 cases. This demonstrated that the vaccine was 94 percent effective in this very young population. The result is highly statistically significant. No serious side effects from the vaccine occurred. The Finnish experience with this vaccine differs from studies carried out in the United States. There is some evidence accumulating that demographic groups such as Alaskan and other native North American populations are relatively unprotected by this vaccine. (Consumer Summary produced by Reliance Medical Information, Inc.)

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Reduction of oropharyngeal carriage of Haemophilus influenzae type b (Hib) in children immunized with an Hib conjugate vaccine

Article Abstract:

Hemophilus influenzae type b (Hib) is a common cause of bacterial infection in children. It causes lung and eye infections and meningitis (inflammation of the brain and spinal cord membranes). These bacteria are present in the mouth and throat (oropharynx) and are spread in the air in the form of aerosolized droplets. It is estimated that 3 to 5 percent of all healthy children are Hib carriers (they have Hib in their mouths or throats but do not have symptoms of infection). However, these rates are higher for children attending day care centers. The best way to prevent an infection with Hib is to prevent the initial colonization or growth of the bacteria in the mouth and throat. A polysaccharide vaccine has been shown to prevent Hib infections in children over 18 months of age. However, it does not prevent Hib from growing in the mouth and throat. A type of vaccine known as a conjugate has been developed with the hope that it will prevent Hib from growing in the mouth and throat. To test the effectiveness of this new vaccine, 725 healthy three-year-old children were studied. The vaccine was given to 327 children and 398 were left untreated. Swabs of the throat and mouth were taken from each child and cultured to determine if Hib was present. None of the children who received the vaccine had Hib in their mouth or throat, while 14 of the children who did not receive the vaccine did have Hib. It is concluded that the Hib conjugate vaccine is effective in preventing Hib from growing in the mouth and throat. (Consumer Summary produced by Reliance Medical Information, Inc.)

Vaccines

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Risk factors for primary invasive pneumococcal disease among children in Finland

Article Abstract:

Children who attend day care centers appear to be at an increased risk for invasive pneumococcal disease. A total of 149 children younger than 16 years with invasive pneumococcal disease were compared with 284 children who did not develop the disease. Parents completed questionnaires about their children's risk factors for the disease. There were no significant differences between the two groups in birth-weight or -length or duration of breastfeeding. Analysis of the questionnaires indicated that attendance at day care centers was significantly associated with an increased risk of the disease. Among children younger than two years a 36-fold increase in risk was found. Attendance at residential, or family, day care centers, which tend to be smaller, was associated with a 4.4-fold increase in risk for the disease. Having siblings who were younger than school age was found to be a risk factor for children who were at least two years old.

Streptococcal infections, Risk factors, Disease transmission, Streptococcus pneumoniae

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