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A Day Care—Based Study of the Efficacy of Haemophilus b Polysaccharide Vaccine
Lee H. Harrison, MD;
Claire V. Broome, MD;
Allen W. Hightower, MS;
Carolyn C. Hoppe, MPH;
Sue Makintubee, RN, MPH;
Sandra L. Sitze, RN, MSN;
Jo A. Taylor, BSN, MPH;
Suzanne Gaventa, MPH;
Jay D. Wenger, MD;
Richard R. Facklam, PhD;
The Haemophilus Vaccine Efficacy Study Group
JAMA. 1988;260(10):1413-1418.
Abstract
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To assess the efficacy of the Haemophilus b polysaccharide vaccine following licensure and to evaluate the risk of Haemophilus influenzae type b (Hib) disease in the week following vaccination, we conducted a day care—based case-control efficacy study using cases of invasive Hib disease ascertained through active surveillance in areas with a total population of 34 million. For each patient 18 to 59 months old, up to three 18- to 59-month-old controls were chosen from the same day care classroom. Using conditional logistic regression, the vaccine efficacy was estimated to be 45% (95% confidence interval = -1% to 70%) and did not change significantly after accounting for potential biases. In addition, three (3%) of 104 patients vs five (2%) of 207 controls were vaccinated within seven days before the patients' dates of admission (odds ratio = 1.8,95% confidence interval = 0.3 to 10.2), which does not suggest an increased risk of Hib disease in the week following immunization. This study suggests that the efficacy of the currently used HBPV is less than expected from previous studies and points out the usefulness of case-control studies for monitoring vaccine efficacy following licensure.
(JAMA 1988;260:1413-1418)
Author Affiliations
From the Meningitis and Special Pathogens Branch, Division of Bacterial Diseases (Drs Harrison, Broome, and Wenger and Ms Gaventa), and the Respiratory Disease Laboratory Section, Division of Bacterial Disease, Center for Infectious Diseases (Dr Facklam), and Statistical Services Activity, Division of Bacterial Diseases (Mr Hightower), Centers for Disease Control, Atlanta; the Los Angeles County Department of Health Services (Ms Hoppe); the Oklahoma State Department of Health, Oklahoma City (Ms Makintubee); the Missouri Department of Health, Jefferson City (Ms Sitze); and the Department of Preventative Medicine, Vanderbilt University School of Medicine, Nashville (Ms Taylor). Additional members of the Haemophilus Vaccine Efficacy Study Group are listed in the acknowledgments.
Footnotes
Reprint requests to Meningitis and Special Pathogens Branch, Centers for Disease Control, Bldg 1, Room 5403, 1600 Clifton Rd, Atlanta, GA 30333 (Dr Harrison).
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