Invasive disease due to Haemophilus influenzae serotype b ten years after routine vaccination, South Africa, 2003-2009

► We reviewed South African laboratory-confirmed Hib disease among children. ► Half of invasive Hib disease was classified as vaccine failures. ► More than half of these vaccine failures were in children older than 18 months. ► Just more than half of these vaccine failures occurred in HIV-uninfected children. ► Additional doses of Hib vaccine in routine programs needs further investigation.