Hib Vaccination: Missing the Forest for the Trees

I realize that I kind of dropped the ball on writing about vaccines.  I wrote about it a lot when I was researching it to make a decision for my family.  Then, there came a point where I was 100% convinced not to vaccinate and I stopped writing about it.

I would like to continue sharing my research about vaccines in the context of why we made the choice not to vaccinate.  Please use the information as a launching point for your own research.

Remeber you can always decide to vaccinate later but you can never unvaccinate.

What is Hib?

Haemophilus influenza type b is a bacterium that colonizes the nasopharynx of healthy people.  Most are asymptomatic while a few individuals, primarily children under the age of 5, will develop invasive disease where the bacterium causes infection.  Infection of the brain and spinal column, called meningitis, is the most frightening possibility and the one the vaccine is designed to avoid.

Remember, meningitis is not a virus or bacteria.  It is a type of infection, like pneumonia, that can be caused by a variety of things including various viruses, bacterium, or fungi.  You can’t “catch” meningitis.

I find that discussion of this vaccine often frame it as a vaccine against meningitis.  I feel this causes a false sense of security.  This is only one way that a person could get meningitis.

Hib is one type of Haemophilus influenza.  There are 6 different types (a-f) as well as “nontypeable” types.  Type b caused the most cases of invasive disease prior to the vaccine.

What are my child’s risk of catching Hib?

According to the CDC’s Pink Book risk factors for Hib include:

  • household crowding,
  • large household size,
  • child care attendance,
  • low socioeconomic status,
  • low parental education levels,
  • school-aged siblings,
  • not breastfeeding

It is also more prevalent in African Americans, Hispanics, and Native Americans and in males more than females.

As with all disease, risk of invasive infection is compounded by poor health or chronic disease such as sickle cell, cancer, etc.

Passive immunity conferred at birth to an infant from the mother is observed in Hib.  As a result infection in babies younger than 6 months is uncommon.

Breastfeeding offers a protective benefit to babies.  The effect was so strong that each additional week of breastfeeding confered measurably more protection.  For example, in this study in the International Journal of Epidemiology

The association of decreased risk for invasive HI infection and long duration of breastfeeding was persisting beyond the period of breastfeeding itself. This finding supports the hypothesis of a long-lasting protective effect of breastfeeding on the risk for invasive HI infection. 

This study also notes that Hib infection skyrocketted in the 70s at a time when breastfeeding rates were at an all time low.

Furthermore, nearly all children develop immunity to Hib before the age of 5 through asymptomatic exposure (see CDC Pink Book pg 88).

What is the Hib Vaccine?

Currently available Hib vaccines are conjugate vaccines.  This means they use a “carrier protein” to elicit an immune system response.  In this case the tetanus bacterium is used with the polysaccharide portion of the Hib bacterium.
Vaccine reactions include:

irritability, sleepiness, injection site pain/soreness, injection site erythema, injection site swelling/induration), unusual high-pitched crying, prolonged crying (>4 hr), diarrhea, vomiting, crying, pain, otitis media, rash, and upper respiratory infection.

Other reactions include transverse myelitis, Guillain-Barre syndrome, thrombocytopenia, anaphylaxis and sudden infant death syndrome.  Additionally, Hib disease can be a result of vaccination.

Does the vaccine work?

Let’s see.

  • 41-55% of Hib disease post-vaccination occurs in those having received at least one shot of the vaccines.
  • The vaccine manufacturers state the efficacy between 59-98% although studies have found efficacy numbers of 31% and lower (source).

Worse yet is what has replaced the previous Hib infections in 0-4 year olds:

  •  56% of invasive disease now occurs in individuals aged >10 years.
  • ” total numbers of invasive Hi infections increased due to a large rise in infections caused by non-capsulated Hi (ncHi) strains (source).”
  • “The number of cases of invasive nontypeable H. influenzae disease increased by 657%, from a low of 7 cases in 1996 to a high of 53 cases in 2004; as a proportion of annual cases, nontypeable H. influenzae disease increased from 17.5% in 1996 to 70.7% in 2004. Overall, the case-fatality rate was 12.7%, with the highest rate observed in persons aged > or = 65 years (20.6%) (source). “
  • The Journal of Infectious Diseases published  a study  which found:
    “The incidence of Hib meningitis decreased 69% during the 1-year period after initiation of Hib immunization (from 2.62 to 0.81 cases/100,000 person-years; P<.001). In contrast, the incidence for H. influenzae type a meningitis increased 8-fold.herefore, Hib immunization contributed to an increased risk for H. influenzae type a meningitis through selection of circulating H. influenzae type a clones.”

In other words, the type b infections have been replaced by and increase in nontypeable HI disease and has shifted outside the normal childhood infection age group.  Meningitis, the main fear behind creating the vaccine, has actually increased 8 fold.

Has this made us safer?  Healthier?

I think the Hib vaccine is a case of saving a tree and not noticing that the forest is burning down around you.  I have ways of protecting my kids from Hib (breastfeeding, healthy living conditions, nutrition, and medical care) without risking the side effects of the vaccine or contributing to the deterioration of global health through tampering with the balance of HI disease.

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14 thoughts on “Hib Vaccination: Missing the Forest for the Trees

  1. I am 19 weeks pregnant with my first, and vaccines are my very least favorite part of parenting already. So much to research. It’s the only thing that doesn’t just hit me as “right” or “wrong”. I do know I do not want 38 vaccines for my kid before the age of 6, so we for sure won’t be getting ALL the vaccines… I am so glad you are going back to this subject!! It is immensely helpful to me as I wade through the vast sea of vaccine-related issues!

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    • It is a very important decision and I’m glad you aren’t taking it lightly Lacey! Have you been t o the Mothering.com forums? Their vaccine board is just full of great information! Good luck with you choice. Let me know if you have any questions – maybe it will be something I can write about!

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  2. Do you know of any good sites for research? Everything I find is propaganda with no sources. Either “vaccinate your kids or you’re killing them” or “don’t vaccinate your kids or you’re killing them.” It would be great if there were a site or two that gave the risks v benefits of each position. Any suggestions?

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  3. Pingback: Sunday Surf 11-13-11 | lovenotesmama

  4. I'm currently reading a book about bacteria and it's role in not only causing disease, but in preventing it and this vaccine is specifically mentioned. My background is biology, I spent years doing cDNA microarray at NIA, and part of the problem with tinkering with biology is whenever you knock an organism out of it's niche, be it by antibiotics, vaccine, genetic engineering, sanitation, etc, something else is poised to take it's place. In Hib's place came a bacteria that causes sinusitis in adults, which seems a fair trade off when preventing meningitis deaths. Interestingly, vaccination for bacterial disease has really decreased the incidence of drug resistance, which is a huge concern of mine.
    My recent post This Way To Kindergarten

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  5. (splitting into multiple comments because of length–it won't let me leave one long comment.) I work with animals now, and we've seen a spike in bladder, ear, skin and wound bacteria that are highly resistant to nearly all the antibiotics we have, leaving us with options that are either prohibitively expensive, or dangerous to use or both. If vaccinating prevents unneccesary antibiotic use and the development of superbugs, I think that's a fair trade off.

    My recent post This Way To Kindergarten

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  6. However, I don't know much about the process of how a vaccine becomes required for schools, etc. I originally declined the HepA vax for my kids but ended up changing my mind because it's a problem where we live. I know there has been research in an ear drop vaccine for children, and many of my friends with kids with tubes who have been on antibiotics a lot would definitely go for it. Neither of mine has had ear issues and would not have needed the vaccine. How does the FDA (or AMA or whomever) decide which vaccines are required and which are optional?
    My recent post This Way To Kindergarten

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    • The CDC recommends the childhood schedule as advised by two groups (I can't think of their accronyms right now but they are comprised of FDA/CDC/and scientists). The individual states make decisions about school entry requirements.

      Thanks for your comments. I certainly think that antiobiotic resistence is a huge problem but what about the actual increase in meningitis? Also the increase in ear infections due to vaccination? I'm on my phone so those are pretty vague – I can be more specific later. I still think the attempt to stop one illness is just creating further problems down the line.

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    • I also didn't know my blog limited comment length. I'll see if I can change that. Thanks for pointing it out!

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