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http://www.reutershealth.com/en/index.html

Vaccine failure risk increased with Hib in combination with acellular pertussis

Last Updated: 2003-05-02 11:04:56 -0400 (Reuters Health)

NEW YORK (Reuters Health) - An increased incidence of Haemophilus influenzae type b (Hib) meningitis among British children born between 2000 and 2001 is associated with a switch in combination vaccine from one containing whole cell pertussis (DTwP-Hib) to one that containing acellular pertussis (DTaP-Hib).

In England and Wales, the incidence of invasive Hib infection rose from 0.65 per 100,000 in 1998 to 4.6 per 100,000 in 2002, Dr. Jodie McVernon of the Communicable Disease Surveillance Centre, London, and associates report in the May 3rd issue of The Lancet. The increased incidence corresponded with a switch to DTaP-Hib, caused by a shortage of the DTwP-Hib.

The researchers identified 110 children with Hib who had received three doses of vaccine before Hib was diagnosed. These cases were each matched by date of birth with 4 to 60 fully vaccinated control subjects living in southeast England.

A higher proportion of cases than controls had received three doses of the acellular pertussis vaccine combination, the report indicates, with a trend for an increased risk of vaccine failure with each additional dose of DTaP-Hib.

Reduced immunogenicity of DTaP-Hib appears to be sufficient to cause an increase in invasive Hib infection, the investigators conclude.

These findings support the clinical relevance of previous observations that DTaP-Hib is associated with reduced Hib antibody titers, Dr. McVernon's group maintains. "Our results emphasize the importance of long-term surveillance of vaccine preventable diseases in the population, especially during changes to routine immunization schedules."

Lancet 2003;361:1521-1523.

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