[Control of Haemophilus influenzae infections].
The results of all clinical trials and mass immunization programmes carried out over the past few years are extremely encouraging and should be the prelude to systematic immunization. Three vaccines that are immunogenic in infants over 6 weeks old, are now available: HbOC linked to diphtheria toxin, PRP-OMP linked to a meningococcus protein, and PRP-T linked to tetanus toxoid. Their safety has been demonstrated particularly when administration at a very early age before the period of risk. Efficacy has been demonstrated, even in population groups who do not respond well to non-conjugate vaccines. Immunogenicity persists even in unfavourable contexts such as individuals with sickle-cell anaemia or leukosis or a previous history of vaccine failure. The duration of immunity amply covers the period of risk and probably a longer because of the booster effect of natural infections. The possibility of combining Hib vaccine with other routine immunizations in infancy will reduce the cost of this additional immunization. Thus it is possible to envisage its integration into immunization programmes in developing countries. Cost/benefit studies show advantages. What is needed now is to achieve high immunization coverage, guaranteeing efficacy of immunization at national level, by ensuring that health personnel as well as families are fully informed about the seriousness of Hib infections and the good tolerance and efficacy of the conjugate vaccines.
Guérin
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Service des maladies transmissibles et vaccinations, Centre international de l'enfance, Paris, France.
D001425:Bacterial Outer Membrane Proteins / Q000191:economics / Q000276:immunology; D002675:Child, Preschool; D002986:Clinical Trials as Topic; D003362:Cost-Benefit Analysis; D004168:Diphtheria Toxoid / Q000191:economics / Q000276:immunology; D006192:Haemophilus Infections / Q000453:epidemiology / Q000517:prevention & control*; D018073:Haemophilus Vaccines / Q000191:economics / Q000276:immunology; D006193:Haemophilus influenzae; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008583:Meningitis, Haemophilus / Q000453:epidemiology / Q000517:prevention & control; D011135:Polysaccharides, Bacterial / Q000191:economics / Q000276:immunology; D011159:Population Surveillance; D013745:Tetanus Toxoid / Q000191:economics / Q000276:immunology; D014611:Vaccination / Q000191:economics / Q000379:methods*; D018074:Vaccines, Conjugate / Q000191:economics / Q000276:immunology
D001425:Bacterial Outer Membrane Proteins; D004168:Diphtheria Toxoid; D018073:Haemophilus Vaccines; C055753:Haemophilus influenza type b polysaccharide vaccine-tetanus toxin conjugate; C052180:Haemophilus influenzae type b-polysaccharide vaccine-diphtheria toxoid conjugate; C061964:Haemophilus influenzae-type b polysaccharide-Neisseria meningitidis outer membrane protein conjugate vaccine; D011135:Polysaccharides, Bacterial; D013745:Tetanus Toxoid; D018074:Vaccines, Conjugate
Contrôle des infections à Haemophilus influenzae.