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This Manual has been designed for use in the NICU at London Health Sciences Centre (LHSC), London, Ontario, Canada, and represents clinical practice at this institution. The information contained within the Manual may not be applicable to other centres. If users of this Manual are not familiar with a drug, it is recommended that the official monograph be consulted before it is prescribed and administered. Any user of this information is advised that the contributors, Editor and LHSC are not responsible for any errors or omissions, and / or any consequences arising from the use of the information in this Manual.

HAEMOPHILUS b CONJUGATE VACCINE
(Act-HIB(R); Connaught)

Indication

  • haemophilus b conjugate vaccine is indicated for the immunization of children 2 months to 59 months of age against invasive disease caused by Haemophilus influenzae type b. (for infants born either prematurely or at term vaccination should be started at the chronologic age of 2 months)
  • Act-HIB(R) is NOT a live vaccine

Pharmacology

  • Haemophilus influenzae type b (Hib) is the most common cause of invasive bacterial disease in young children
  • approximately 55 to 65% of all invasive Hib infections present as meningitis; Hib can also result in epiglottitis, septicemia, cellulitis, pneumonia and other invasive conditions
  • other strains of H. influenzae (non type b) are commonly found in otitis media, sinusitis, bronchitis and other upper respiratory tract infections; these conditions are seldom associated with type b organisms
  • Act-HIB(R) (the brand that we will be using at SJHC) is a conjugate vaccine: it contains a purified capsular polysaccharide of H.influenzae (type b) bound to tetanus protein; a conjugate vaccine results in stimulation of the immune system

Side Effects

  • local reactions including pain, redness, swelling and induration may occur at injection site
  • systemic reactions including fever, irritability, drowsiness, prolonged or abnormal crying, vomiting have occurred
  • high fever, serious local reactions and systemic reactions temporally associated with injection must be reported to the medical officer of health (Middlesex-London Public Health Unit (519)663-5317)

Precautions

  • Act-HIB(R) is the infant Hib conjugate vaccine which is supplied free of charge in Ontario; indicate the TRADE NAME both in the infant's chart AND personal immunization record
  • Connaught's DPT Polio Adsorbed vaccine may be used for the reconstitution of the lyophilized (freeze-dried powder) Act-HIB(R). This provides an efficient means of administering routine immunization against diphtheria, pertussis, tetanus, poliomyelitis and H.influenzae type b in a single injection
  • note that Hib vaccine will not prevent meningitis due to non-Hib infectious agents, such as meningococci or streptococci

Dose

  • 0.5 mL IM, after reconstitution with Connaught's DPT Polio adsorbed vaccine

Supplied

  • Act-HIB(R) is supplied as a lyophilized powder. It may be reconstituted with Connaught's DPT Polio Adsorbed vaccine (which is sold under the trade name QUADRACEL(R)) as follows:
    1. Shake the ampoule (DPT Polio Adsorbed vaccine - QUADRACEL(R)) well to uniformly distribute the suspension before withdrawing the contents.
    2. Inject all of the DPT Polio Adsorbed vaccine - QUADRACEL(R) into the vial of Act-HIB(R) (ie. the lyophilized powder)
    3. Swirl the vial until a cloudy, uniform suspension results. Avoid foaming.

References

  1. "HibTiter" Product Monograph, Lederle Laboratories, 1992.
  2. National Advisory Committee on Immunization: Statement on Haemophilus influenzae type b conjugate vaccines for use in infants and children, Can Med Assoc J 1992; 146: 1363-1366.
  3. Ontario Ministry of Health: Introduction of infant Haemophilus b vaccine in Ontario - information for health care providers, September 1992.
  4. Haemophilus b Conjugate Vaccine, Product Monograph, Pasteur Merieux Connaught, Rhone-Poulenc Group, May 1997.

Updated: February 2000

RECOMMENDED ROUTINE IMMUNIZATION SCHEDULE FOR INFANTS BEGINNING SERIES IN EARLY INFANCY
AGE
VACCINE
2 monthscDPT Polio* + Act-Hib
4 monthscDPT Polio* + Act-Hib
6 monthscDPT Polio* +Act-Hib
after 1st birthdayMMR
18 monthscDPT Polio* +Act-Hib
4-6 yearscDPT Polio*
MMR
12 yearsHepatitis B (3 doses)
14-16 yearsTd Polio

SOURCE: Ontario Ministry of Health, Public Health Branch, July 1997

*cDPT refers to 'component' pertussis, an acellular pertussis vaccine composed of 5 purified pertussis antigens. This is present in DPT Polio Adsorbed vaccine - QUADRACEL(R)

Updated: February 2000




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