Incidence of Haemophilus influenzae type b meningitis during 18 years of vaccine use: observational study using routine hospital data

• Published in: BMJ Vol. 330; no. 7481; pp. 18 - 19
• Main Authors: Peltola, Heikki, Salo, Eeva, Saxén, Harri
• Format: Journal Article
• Language: English
• Published: London British Medical Journal Publishing Group 01.01.2005; British Medical Association; BMJ Publishing Group LTD; BMJ Publishing Group; BMJ Publishing Group Ltd
• Edition: International edition
• Subjects: Antibodies; Bacterial Capsules; Biological and medical sciences; Child, Preschool; Conjugate vaccines; Dosage; Finland - epidemiology; General aspects; Haemophilus influenzae type b; Haemophilus meningitis; Haemophilus Vaccines; Humans; Immune system; Immunization; Immunology; Incidence; Infant; Infant, Newborn; Infectious diseases; Medical sciences; Meningitis; Meningitis, Haemophilus - epidemiology; Meningitis, Haemophilus - prevention & control; Meningococcal meningitis; Polysaccharides; Polysaccharides, Bacterial; Vaccination; Vaccines; Whooping cough; Finland; United Kingdom > UK; Netherlands; Nervous system diseases; Vaccine; Use study; Epidemiology; Haemophilus influenzae; Incidence; Pasteurellaceae; Medicine; Prevention; Immunoprophylaxis; Central nervous system disease; Bacteria; Meningitis; Hospital; Public health
• ISSN: 0959-8138; 0959-8146; 1468-5833; 1756-1833
• DOI: 10.1136/bmj.38301.657014.79

Replacement of serotypes other than Hib in severe diseases has also raised concern. Because H influenzae meningitis in the Greater Helsinki area has been recorded since 1939, we had a unique opportunity to investigate any impact of vaccination. What is already known on this topic The official recommendation is four doses for the most widely used Haemophilus influenzae type b (Hib) conjugate vaccines; despite this, Finland has been using only three vaccine doses since 1988 with excellent clinical effectiveness What this study adds Two Hib vaccine doses in early infancy with a late booster is efficacious and may practically eliminate Hib meningitis Attention should be paid to the clinical effectiveness of Hib conjugates rather than surrogate antibody measurements, which we often cannot interpret correctly Epidemiological data are probably more relevant than antibody measurements, which are not always correctly interpreted.