HIB vaccination

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The Hib vaccination (also known as the HIB vaccination ) is a vaccination against the Haemophilus influenzae type b bacterium to prevent Haemophilus influenzae b infection . It is not directed against other serotypes. The Hib vaccine is on the World Health Organization's Essential Medicines List .

properties

The vaccine consists of a protein- bound epitope of the capsular polysaccharide b. Especially in small children (peak frequency before vaccination in the 6th to 7th month of life) this bacterium is a causative agent of meningitis (meningitis) and other inflammatory diseases in the ear, nose and throat area, such as epiglottitis . Since some strains of Haemophilus influenzae are already resistant to known antibiotics , the Hib vaccination has been recommended for all small children by the Standing Vaccination Commission (STIKO) since 1990 .

The Hib vaccination is usually part of a combination vaccination, e.g. B. the vaccinations against Hib, tetanus , diphtheria , whooping cough , polio and hepatitis B can be injected together in a six-fold vaccine . The Hib vaccination is not refreshed later as Hib infections are rare after the age of five. The purified polysaccharide of the bacterial capsule , which is produced as a virulence factor by the pathogenic strains of H. influenzae , is used as the inoculation substance . Since the capsular polysaccharide is a T-cell-independent antigen , it is not sufficient to achieve sufficient vaccination success in children under 18 months - they are only effective antigens if the immune system of an adolescent / adult is mature. The saccharide itself is therefore a so-called hapten .

Therefore, the vaccine antigen of the Hib vaccination is coupled to additional, T-cell-activating antigens such as diphtheria toxoid , tetanus toxoid or capsule material from Neisseria meningitidis ( conjugate vaccine ). The additional simultaneous vaccination in combination vaccines also increases the success of the vaccination, which is why monovalent Hib vaccines are rarely used for small children. The amount of antigen in the carrier used in the Hib component (e.g. the diphtheria toxoid or tetanus toxoid) itself is so small that there is no immunity to diphtheria or tetanus.

Vaccination schedule

From the age of two months onwards, three vaccinations are usually given in Germany every four weeks (2nd, 3rd and 4th month) with combination vaccines (basic immunization), and then in the 11th to 14th month of life a fourth vaccination as a booster vaccination (3+ 1 scheme). The booster vaccination is given so that it counteracts the falling vaccination titer. The vaccination in the 3rd month is not required for vaccines without pertussis components. If the first vaccination is delayed from the age of one to four, only one vaccination is given. Thereafter, a Hib vaccination is only indicated in exceptional cases.

In Austria , however, a new vaccination scheme has already been introduced for the six-fold vaccination , so that children there are usually vaccinated against Hib three times (in the 3rd, 5th and 11th-12th month of life) (2 + 1 scheme).

The 2 + 1 scheme also applies to Switzerland . There the first two doses are scheduled at the age of 2 and 4 months, the third vaccination takes place at the age of 12 months.

A single Hib vaccination is indicated for adults without a spleen or with functional asplenia .

Side effects

Local redness and swelling at the injection site were observed in 1–2% of the individual vaccines, and rarely irritability , apathy , vomiting and fever . In the case of combination vaccinations, the Hib component has only a low reactogenicity.

Individual evidence

  1. ^ WHO Model Lists of Essential Medicines. (PDF) In: WHO. 2019, accessed April 4, 2020 .
  2. ↑ a b c d Thiên-Trí Lâm and Ulrich Vogel: Haemophilus . In: Sebastian Suerbaum, Gerd-Dieter Burchard, Stefan HE Kaufmann, Thomas F. Schulz (eds.): Medical microbiology and infectious diseases . Springer-Verlag, 2016, ISBN 978-3-662-48678-8 , pp. 285-286 , doi : 10.1007 / 978-3-662-48678-8_33 .
  3. ↑ a b Herbert Hof and Rüdiger Dörries: Medical Microbiology . 5th edition. Thieme, Stuttgart 2014, ISBN 978-3-13-152965-7 , pp. 428 .
  4. ↑ H. Spiess, U. Heininger: Impfkompendium. 6th edition, Stuttgart 2005 pp. 216f
  5. ↑ Robert Koch Institute: Recommendations of the Standing Vaccination Commission (STIKO) at the Robert Koch Institute / Status: August 2019 In: Epidemiologisches Bulletin . August 22, 2019 / No. 3, p. 225, ISSN  1430-0265 ( PDF; 945 kB )
  6. ^ Vaccination plan Austria 2020. Federal Ministry for Social Affairs, Health, Care and Consumer Protection, accessed on January 24, 2020 .
  7. ↑ Swiss vaccination plan. In: Federal Office of Public Health . February 14, 2020, accessed March 20, 2020 .
  8. ^ Ulrich Heininger: Haemophilus influenzae type b . In: Heinz Spiess, Ulrich Heininger, Wolfgang Jilg (Eds.): Impfkompendium . 8th edition. Georg Thieme Verlag, 2015, ISBN 978-3-13-498908-3 , p. 176 .

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