Immunoglobulin deficiency and idiotype expression in children developing Haemophilus influenzae type b disease after vaccination with conjugate vaccine

Article Abstract:

Although Haemophilus influenzae type b (Hib) vaccines are effective in preventing the disease in most children, they sometimes fails to prevent infection. When H. influenzae type b polysaccharide (Hib PS) unconjugated vaccine was licensed in 1985, the vaccine was less effective than had been expected based on a study in Finland. At the end of 1987 a conjugate vaccine (combined with a protein to enhance the immune response) combined with diphtheria toxoid (Hib PS-D) was brought to market. Although the new vaccine is highly effective, some children have developed Hib disease in spite of vaccination. To discover why this occurred, 23 patients who developed Hib disease two weeks or more after vaccination were studied. The findings were compared with those from 149 patients who became infected with Hib after vaccination with the unconjugated vaccine, and from 90 unvaccinated patients who also developed the disease. Every one of the children who developed the disease after vaccination with the Hib conjugate vaccine had abnormally low immunoglobulin (Ig) levels, specifically IgG2. From a practical standpoint, this indicates that Ig concentrations, including IgG2, should be measured in all patients, even though they do not have recurrent infections. In addition, children with deficient immune responses should be revaccinated with conjugate vaccine, because they are at increased risk of having a recurrence of the disease. Most children respond to revaccination, and those who do not should be evaluated for therapy for immunodeficiency. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Prevention, Complications and side effects, Children, Vaccination of children, Vaccination, Immunoglobulins, Immunodeficiency, Hemophilus influenzae, Haemophilus influenzae

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Declining incidence of Haemophilus influenzae type b disease since introduction of vaccination

Article Abstract:

The use of vaccines against the bacterium Hemophilus influenzae type b (Hib) may be responsible for the dramatic reduction in Hib disease in Minnesota and Dallas County, TX. The first Hib vaccine was introduced in 1985 followed in 1988 by a more effective conjugate vaccine. Reports of Hib disease in children between 18 months and five years in Minnesota and Dallas show that the incidence of Hib disease remained stable between 1983 and 1987, but subsequently dropped over 85%. Much of the decline occurred after 1989, one year after the conjugate vaccine was introduced. Between 1983 and 1989, the incidence of Hib disease also dropped significantly in infants less than 18 months old even though the vaccine was not licensed for use in this group until 1990. The conjugate vaccine has been shown to reduce bacterial colonization in the throat. Consequently, vaccinated children might be less likely to transmit the infection to infants.

Usage, Demographic aspects, Hemophilus infections

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Avidity and bactericidal activity of antibody elicited by different Haemophilus influenzae type b conjugate vaccines

Article Abstract:

Evaluation of new vaccines should include a test of antibody avidity, or the ability of antibodies raised by the vaccine to bind to the infecting microorganism. Hib vaccines protect children from infection with Haemophilus influenzae type b, the major cause of serious bacterial infections in children. Blood samples were taken from 171 children a month after their final vaccination with one of three different Hib vaccines: Oligo-CRM, PRP-OMPC or PRP-T. The blood was tested for antibody avidity. Blood samples from children vaccinated with Oligo-CRM exhibited the highest antibody avidity; samples from those vaccinated with PRP-OMPC exhibited the lowest antibody avidity. Samples from those vaccinated with PRP-T exhibited antibody avidity higher than PRP-OMPC but lower than Oligo-CRM. Blood samples with high antibody avidity were more effective in killing Hib bacteria in culture than those with low antibody avidity.

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