Health Advisory
UPDATE: CDC REINSTATES 4 DOSE HAEMOPHILUS INFLUENZAE
TYPE B HIB SCHEDULE

The Delaware Division of Public Health (DPH) is issuing this alert as an update to the previous announcement regarding the deferral of the routine Haemophilus influenzae type B (Hib) vaccine booster administered at age 12-15 months. This deferral was recommended because of a shortage of the vaccine. Supplies are now sufficient to reinstate the routine booster (4th) dose of Hib vaccine for children 12-15 months.

Updated Guidance:

• Continue administering the primary Hib vaccine series to infants at ages 2, 4, 6 months. Reinstate the booster dose at 12-15 months as of July 1, 2009.
• Children who had the booster dose deferred at 12-15 months should receive their booster dose at the next routinely scheduled well child visit or medical encounter. Monovalent Hib vaccine (ActHIB) is the recommended vaccine for children who were deferred for the booster and have received 4 doses of DTaP. If DTaP-IPV/Hib (Pentacel) is the only available Hib containing vaccine and the child has received the recommended doses (4) DTaP and (3) IPV, providers may consider use of Pentacel as the Hib booster.
• DPH recommends that providers identify the children deferred for the booster dose and flag their records before the scheduled well child visit.

Note that the supply of Hib vaccine is not ample to support a mass notification to contact all children with deferred Hib booster doses. However, supplies are sufficient to begin catch-up at regularly scheduled well child visits and medical encounters

This updated guidance was made by the Centers for Disease Control and Prevention (CDC) in consultation with Advisory Committee on Immunization Practices (ACIP), American Academy of Family Physicians (AAFP), and American Academy of Pediatrics (AAP) in the Morbidity and Mortality Weekly Report June 26, 2009/58(24); 673-674. The production of Merck Hib vaccine products remains suspended and has been since December 2007. During the Hib vaccine shortage, Sanofi Pasteur has been providing two Hib-containing vaccines, monovalent Hib vaccine (ActHIB and DTaP-IPV/Hib (Pentacel). Sanofi Pasteur will manufacture an increasing number of doses of ActHIB and Pentacel beginning in July 2009. This effort is expected to result in a sufficient supply to reinstate the Hib vaccine booster dose recommendation.

Additional information

• Delaware Immunization Program at 1-800-282-8672 or visit
• Hib schedule.http://www.cdc.gov/vaccines/recs/schedules/default.htm#child
• CDC announcement of updated guidance: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5824a5.htm?s_cid=mm5824a15e

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