Prevention of Haemophilus influenzae type b infections in Apache and Navajo children.
Prospective surveillance of Haemophilus influenzae type b (Hib) disease has been done since 1981 in two high-risk populations, White Mountain Apaches and Navajos. The attack rate in children less than 5 years of age is 5-10 times higher than in the general US population. Three vaccines were evaluated. Unconjugated Hib capsular polysaccharide produced lower antibody responses in 18- and 24-month-old Apache infants than in white infants. HbOC (Hib oligosaccharide covalently linked to the nontoxic mutant diphtheria toxin CRM197) produced low antibody responses in Navajo infants after one or two doses but induced responses similar to those in whites after three doses. The responses of 18-month-old Navajos to HbOC were lower than those of whites, but most achieved protective levels. PRP-OMP (Hib capsular polysaccharide linked to the outer membrane protein complex of Neisseria meningitidis) produced good immune responses in 2-month-old Navajo and Apache infants after a single dose. This vaccine was greater than 90% efficacious in protecting Navajo infants from Hib disease when given at 2 and 4 months of age. Even a single dose achieved a high protective efficacy.
Santosham
M
M
Center for American Indian and Alaskan Native Health, Department of International Health, Johns Hopkins University School of Hygiene and Public Health, Baltimore, MD 21205.
Rivin
B
B
Wolff
M
M
Reid
R
R
Newcomer
W
W
Letson
G W
GW
Almeido-Hill
J
J
Thompson
C
C
Siber
G R
GR
D000907:Antibodies, Bacterial / Q000096:biosynthesis / Q000097:blood; D016667:Bacterial Capsules; D001425:Bacterial Outer Membrane Proteins / Q000009:adverse effects / Q000276:immunology; D001426:Bacterial Proteins / Q000009:adverse effects / Q000276:immunology; D001428:Bacterial Vaccines / Q000009:adverse effects / Q000276:immunology; D002675:Child, Preschool; D015331:Cohort Studies; D004306:Dose-Response Relationship, Immunologic; D005260:Female; D006192:Haemophilus Infections / Q000453:epidemiology / Q000517:prevention & control*; D018073:Haemophilus Vaccines; D006193:Haemophilus influenzae / Q000276:immunology*; D006801:Humans; D015994:Incidence; D007198:Indians, North American; D007223:Infant; D008297:Male; D008583:Meningitis, Haemophilus / Q000453:epidemiology / Q000517:prevention & control; D011135:Polysaccharides, Bacterial / Q000009:adverse effects / Q000276:immunology; D012189:Retrospective Studies; D014611:Vaccination; D014614:Vaccines, Synthetic / Q000276:immunology
D000907:Antibodies, Bacterial; D001425:Bacterial Outer Membrane Proteins; D001426:Bacterial Proteins; D001428:Bacterial Vaccines; D018073:Haemophilus Vaccines; C044237:Haemophilus influenzae type b polysaccharide vaccine; C061964:Haemophilus influenzae-type b polysaccharide-Neisseria meningitidis outer membrane protein conjugate vaccine; D011135:Polysaccharides, Bacterial; D014614:Vaccines, Synthetic; C061963:HibTITER protein, Haemophilus influenzae