Haemophilus influenzae type b vaccination (Hib)
and Florian Tiefenböck, doctorFlorian Tiefenböck studied human medicine at the LMU Munich. In March 2014, he joined as a student and has supported the editorial team with medical articles ever since. After receiving his medical license and practical work in internal medicine at the University Hospital Augsburg, he has been a permanent member of the team since December 2019 and, among other things, ensures the medical quality of the tools.
More posts by Florian Tiefenböck All content is checked by medical journalists.The vaccination against Haemophilus influenzae type b protects children from life-threatening infections in the ear, nose and throat area. Read everything you need to know about the Hib vaccination here!
What is Haemophilus influenzae type b?
Haemophilus influenzae type b (Hib) is a bacterium that can cause life-threatening, inflammatory diseases in the ear, nose and throat area in children (e.g. otitis media, sinus infections). The epiglottitis is a particularly feared complication: there is a risk of suffocation. Inflammation of the lungs (pneumonia) or purulent meningitis (meningitis) are also dangerous: despite treatment, hearing damage and developmental disorders can remain. Sometimes it is fatal, especially if the affected person develops bacterial blood poisoning (sepsis).
How important is vaccination?
Severe Hib infections are most common in the first five years of life. About 50 percent of all Hib meningitis affect infants in the first year of life. If the Hib infection is not treated quickly enough, it can be fatal. Another problem is that some Hib strains no longer respond to antibiotics, which makes therapy more difficult.
That is why vaccination has been recommended by the Standing Vaccination Commission (STIKO) for all infants and young children since 1990. It has led to a significant decrease in the disease and saved many children from permanent damage. Nowadays the disease mainly affects seniors, unvaccinated people and people for whom the vaccination did not produce proper immune protection (vaccination failures).
In addition to the basic immunization in the first year of life, the STIKO experts recommend people with a missing or non-functioning spleen to be vaccinated against Hib. This so-called indication Hib vaccination is in principle advisable for risk groups, i.e. people who have an increased risk of illness and complications.
The Haemophilus influenzae type b vaccination not only protects the vaccinated person, but also those who are particularly at risk (weak immune systems, infants, toddlers)!
What is the vaccination schedule?
The primary vaccination series for infants is usually given at the same time as other standard vaccinations. The children receive a so-called six-fold vaccination. It works against diphtheria, tetanus, polio, whooping cough, hepatitis B and Haemophilus influenzae type b.
For the basic immunization, the STIKO has been recommending a total of three vaccination appointments since June 2020. The first two vaccinations are supposed to build up immune protection, the third a good six months later then serves as a booster. Experts therefore also speak of the 2 + 1 vaccination scheme.
Doctors usually administer the Haemophilus influenzae type b vaccination during the primary vaccination course during the first year of life:
- The first Hib vaccination takes place in the 2nd month of life
- The second Hib vaccination is given to infants at the age of 4 months
- In the 11th month of life, the doctor injects the third and usually last vaccination against Haemophilus influenzae type b
For children born before the 37th week of pregnancy, the experts still recommend four vaccinations. Premature babies receive the so-called 3 + 1 vaccination schedule with an additional syringe in the third month of life.
Some combination vaccines are not (yet) approved for the reduced 2 + 1 vaccination schedule. If only one such vaccine is available, doctors give the vaccination four times (in months 2, 3, 4 and 11)!
How long does the vaccination last?
The vaccination protection is very reliable. After the primary vaccination course, the child is protected from Hib infection for several years. General booster vaccinations are not necessary as severe Hib infections are less common after the age of five.
How is vaccination done?
The vaccine is given by injection into a muscle (intramuscularly, IM), either in the side of the thigh muscle or in the upper arm.
The vaccination is a dead vaccine that only contains characteristic structures (antigens) of the bacterium. This means that the vaccination is well tolerated. The Hib vaccine itself is usually a so-called polysaccharide vaccine. The Hib polysaccharide is usually bound (conjugated) to a tetanus protein together with a special agent (adsorbent) in order to achieve a better effect.
Postpone the vaccination, in consultation with your doctor, if your child has a high fever or is seriously ill. Then the immune system is busy defending itself against other pathogens and may not produce any antibodies against the Hib pathogen. A slight cold, on the other hand, is not an obstacle to vaccination.
possible side effects
The side effects depend on the combination of the vaccines, but are generally harmless. The Hib vaccine sometimes causes reddening of the skin, small swelling or hardening of the skin at the vaccination site, which usually goes away on its own. Occasionally, one also observes slight general reactions such as fatigue, gastrointestinal complaints or temperature increases.
Fever, in particular, can be a common side effect. In individual cases this can lead to a febrile seizure, which, however, usually has no consequences. A hypotonic-hyporesponsive episode (HHE) is just as rare and usually without consequences: the child's muscles slacken and the child is temporarily unresponsive. After a short period of time (six to 30 minutes), this shock-like state is usually over.
Ultimately, allergic reactions can also occur after a Haemophilus influenzae type b vaccination.
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