Other brands: Act-HIB®
Vaccine type: subunit conjugate
Schedule and administration
After 1 July 2017, the Hiberix® brand of Haemophilus influenzae type b (Hib) vaccine will replace Act-HIB®. The vaccines are fully interchangeable. Hiberix is delivered as part of the National Immunisation Schedule at 15 months to booster Hib protection delivered in the first year of life as part of Infanrix®-hexa vaccine.
Hiberix is licensed for use in infants and children 2 months to 5 years of age. It is used out of licensure in children 5 years of age and over and adults as there is no alternative vaccine available in New Zealand for these age groups. No safety concerns are expected for use in older age groups.
Children under 2 years with invasive Hib disease do not always produce protective antibodies and therefore should be considered susceptible and receive a complete course of Hib vaccination as soon as possible during convalescence.
Special groups
An additional dose of Hiberix is funded (as appropriate) for (re-)immunisation of individuals:
- cochlear implant (pre- or post-)
- functional asplenia
- post-chemotherapy
- post-haematopoietic stem cell transplantation
- pre- or post-solid organ transplantation
- pre- or post-splenectomy
- renal dialysis
- severely immunosuppressive regimen
Catch-up doses
In children 12 months to 5 years of age a single dose of Hib vaccine is required, regardless of doses given in the first year of life.
For children under 5 years of age, refer to Appendix 2 in the Immunisation Handbook 2017: Planning immunisation catch-ups.
For older children and adults with an eligible medical condition, missed doses of Hiberix can be given at any time.
Storage and preparation
Store vaccine and diluent as per cold chain between 2°C to 8°C.
Administration
Hiberix can be administered concurrently with other vaccines, including all National Immunisation Schedule vaccines. Separate syringes and different injection sites should be used.
Intramuscular injection is the preferred method of administration.
Vaccine safety
More than 20 years of studies and safety monitoring have shown that Hib vaccines have excellent safety profiles. No serious reactions to this vaccine have been identified.
Administration of Hiberix should be postponed in individuals suffering from a fever over 38°C. The presence of a minor infection is not a reason to delay immunisation.
Hiberix should not be given to:
- Anyone with severe allergy (anaphylaxis) to a previous dose of this vaccine or other Hib containing vaccine, or a component of the vaccine.
Advice should be sought for the following groups:
- Those with bleeding disorders, such as haemophilia. The vaccine should be administered in accordance with the haematologist’s instructions. It may, in this situation only, be given subcutaneously
Vaccine effectiveness
Hiberix vaccine contains a polysaccharide from the outside of the Hib bacterium conjugated to tetanus toxoid.
Around 95% of invasive Hib disease was caused by Haemophilus influenzae type b prior to the introduction of the vaccine. The remainder of invasive Hib disease is caused by a further five encapsulated (typeable) serotypes and unencapsulated (non-typeable) serotype for which there are currently no vaccines. Since introduction in1994, Hib conjugate vaccines have been highly successful in reducing Hib disease in young children. Prior to the introduction of Hib vaccines on the New Zealand National Immunisation Schedule, there were approximately 150 infant cases per 100,000 people. This incidence fell dramatically to around 0.2 cases per 100,000 within a year following introduction of the Hib vaccine. In 2015, there were just three laboratory confirmed cases, all of which were in unvaccinated children under 5 years of age. [See also Infanrix-hexa for primary course Hib vaccine]
Clinical efficacy of Hiberix has been estimated to be 95-100% and more than 95% of infants will produce protective antibody after the primary series.
Limited data suggest that immune tolerance may be induced in infants given Act-HIB BEFORE 6 weeks of age and this may reduce the response to subsequent doses.
