Estimating Haemophilus influenzae Type b Vaccine Effectiveness in England and Wales by Use of the Screening Method
Abstract
In October 1992, Haemophilus influenzae type b (Hib) conjugate vaccine was introduced to infants in the United Kingdom with a "catch-up" program for those aged <4 years. Initially, the rate of invasive Hib disease decreased dramatically but has been increasing since 1999. To determine possible reasons for this increase, the effectiveness of Hib conjugate vaccine was estimated by use of the screening method. Between October 1993 and December 2001, a total of 443 cases of Hib infection occurred in children eligible for vaccination; 363 (82%) were fully vaccinated. Vaccine effectiveness was estimated to be 56.7% (95% confidence interval, 42.5-67.4). Effectiveness was lower in children vaccinated during infancy, compared with those who were vaccinated during the catch-up campaign (P=.0033), declined with time since vaccination (P=.0008), and was lower in children born during 2000-2002, compared with other children scheduled for infant vaccination (P=.0041). Use of a catch-up vaccination program enhanced the control of Hib infection in England and Wales. Since 1999, however, low effectiveness in infants, declining effectiveness with age, and the use of lower-efficacy vaccines have contributed to increased rates of Hib infection. The potential role of boosters needs to be considered.
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Protein-polysaccharide conjugate vaccines contain the same polysaccharides from the bacterial surface chemically conjugated to a protein carrier.
“Protein–polysaccharide conjugate vaccines contain the same polysaccharides from the bacterial surface, but in this case they are chemically conjugated to a protein carrier (mostly tetanus toxoid, or diphtheria toxoid or a mutant protein derived from it, known as CRM197)32–34.”
From A guide to vaccinology: from basic principles to new developments (2021) · cites this paper as [34]
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- Authors
- Ramsay, M. E., McVernon, J., Andrews, N. J., Heath, P. T., & Slack, M. P.
- Affiliations
- Public Health Laboratory (MO)
- John Radcliffe Hospital (GB)
- St George's, University of London (GB)
- Corresponding author
- Ramsay, Mary E.
- Venue
- The Journal of Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2003-08-15
- Volume
- 188
- Issue
- 4
- Pages
- 481-485
- ISSN
- 0022-1899 (ISSN-L)
- 1537-6613
- OpenAlex
- W2114663173
- Cited by
- 172
- References
- 20
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 4 · 2023: 3 · 2022: 2 · 2021: 4 · 2020: 2 · 2019: 2 · 2018: 3 · 2017: 7 · 2015: 3 · 2014: 8 · 2013: 11 · 2012: 10
- FWCI
- 12.06
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Immunology and Microbiology › Microbiology › Bacterial Infections and Vaccines
- Health Sciences › Medicine › Epidemiology › Pneumonia and Respiratory Infections
- Social Sciences › Health › Vaccine Coverage and Hesitancy
- Keywords
- Haemophilus influenzae type b, Hib conjugate vaccine, vaccine effectiveness, screening method, invasive Hib disease, catch-up vaccination, infants, waning vaccine effectiveness, booster vaccination, England and Wales
- MeSH terms
- Child, Child, Preschool, England, Female, Haemophilus Infections, Humans, Infant, Male, Vaccination, Wales, Incidence, Treatment Outcome, Haemophilus Vaccines, Vaccines, Conjugate
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