There are very few individuals who cannot receive Hib-containing vaccines
- if in doubt, appropriate advice should be sought from a consultant paediatrician, immunisation co-ordinator or consultant in communicable disease control rather than withhold vaccine
- vaccines should not be given to those who have had:
- a confirmed anaphylactic reaction to a previous dose of a Hib-containing vaccine, or
- a confirmed anaphylactic reaction to any components of the vaccine
Confirmed anaphylaxis occurs extremely rarely. Data from the UK, Canada and the US point to rates of 0.65 to 3 anaphylaxis events per million doses of vaccine given (1).
Minor illnesses without fever or systemic upset are not valid reasons to postpone immunisation.
Systemic and local reactions following a previous immunisation
- in consideration of children with a history of a severe or mild systemic or local reaction within 72 hours of a preceding vaccine
- immunisation with Hib-containing vaccine should continue following a history of (1):
- fever, irrespective of its severity
- hypotonic-hyporesponsive episodes (HHE)
- persistent crying or screaming for more than three hours, or
- severe local reaction, irrespective of extent
pregnancy and breast-feeding
- Hib-containing vaccines may be given to pregnant women when protection is required without delay - no evidence of risk from vaccinating pregnant women or those who are breast-feeding with inactivated viral or bacterial vaccines or toxoids
Check the the relevant Green Book chapter for up-to-date details.
Check the Summary of Product Characteristics before prescribing/administering a Hib-containing vaccine.
Notes:
- if an individual is acutely unwell, immunisation may be postponed until they have recovered. This is to avoid confusing the differential diagnosis of any acute illness by wrongly attributing any signs or symptoms to the adverse effects of the vaccine
Reference:
- Immunisation Against Infectious Disease - "The Green Book".Chapter 16 Haemophilis influenzae type B (Hib) (April 2019)