Haemophilus influenzae type b conjugate vaccines – A South African perspective

Introduction of Hib vaccine is known to positively impact on reduction of both morbidity and mortality in children less than 5 years of age. Incorporation of this vaccine into a National EPI, however, does come at a significant cost, which is especially important in non-GAVI funded countries. Compounded reduction in response in certain patient populations and possible indication of booster doses further impacts on cost-benefit analyses. Despite these issues, South Africa has supplied Hib vaccine as part of the National EPI in the form of a combination vaccine, Pentaxim®, which combines Hib with Diphtheria, Tetanus, acellular Pertussis (DTP) and Poliomyelitis since 2009. Prior to this, another combination vaccine was utilized containing Hib and DTP. This has subsequently lead to a significant reduction in invasive Hib disease post-introduction, therefore largely justifying utilization.

► South Africa first introduced Hib vaccine in 1999 without external funding. ► This has significantly reduced invasive Hibdisease. ► HIV positive patients seem to have lower antibody titers than HIV negative patients. ► Recent Hib vaccine failures have prompted addition of a booster dose at 18 months. ► The impact of this intervention is yet to be seen.