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Efficacy of Haemophilus influenzae type b vaccination of children: a meta-analysis

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Abstract

Haemophilus influenzae type b (Hib) infection is a leading cause of meningitis and pneumonia in infants and children in developing countries, and yet the implementation of routine Hib vaccination is very slow. The aim of the present study was to quantify the protective efficacy of H. influenzae type b vaccination of young children. MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials Register were searched. References of selected articles were also reviewed and experts contacted. Eight randomized trials were found that compared the efficacy of H. influenzae type b conjugate vaccine to placebo or no vaccine. Information on study design, patients enrolled, age, vaccine type, cases of invasive H. influenzae type b disease, adverse events, and items to assess potential for bias was recorded. The incidence of invasive H. influenzae type b infection formed the primary outcome. The odds ratio (OR) of developing Hib infection was combined using a random effects model to provide a measure of vaccine efficacy. The protective effect, defined as the relative risk reduction, was estimated as (1-OR). From eight trials, the protective efficacy of the Hib conjugate vaccine was 84% (OR 0.16; 95%CI 0.08–0.30) against invasive Hib disease, 75% (OR 0.25; 95%CI 0.08–0.84) against meningitis, and 69% (OR 0.31; 95%CI 0.10–0.97) against pneumonia. Serious adverse events were rare. The results provide firm evidence that Hib conjugate vaccines are safe and effective in reducing the risk of all forms of invasive Hib disease, further establishing that vaccination of children in developing countries can protect them from a potentially fatal yet preventable disease.

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Acknowledgements

C.O.O. is supported by a fellowship from the International Training on Medical Informatics (ITMI), awarded by the National Institutes of Health, Fogarty International Center, through the New England Medical Center and Tufts University Medical School, Boston, MA. J.L. is supported in part by a grant from the Agency for Healthcare Research and Quality (R25 HS09796), of the U.S. Public Health Service. We appreciate comments made on earlier drafts of this manuscript by Drs. Richard Adegbola, Jay Wenger, and Trudy Murphy and the two anonymous reviewers. We thank the director of the Kenya Medical Research Institute (KEMRI) for permission to publish these results.

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  1. Centre for Vector Biology & Control Research, Kenya Medical Research Institute, PO Box 1578, Kisumu, 40100, Kenya

    C. O. Obonyo

  2. Tupper Research Institute, Division of Geographic Medicine and Infectious Diseases, New England Medical Center/Tufts University Medical School, Boston, MA, 02111, USA

    C. O. Obonyo

  3. Institute of Clinical Research and Health Policy Studies, Tufts-New England Medical Center, Boston, MA, 02111, USA

    J. Lau

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Obonyo, C.O., Lau, J. Efficacy of Haemophilus influenzae type b vaccination of children: a meta-analysis. Eur J Clin Microbiol Infect Dis 25, 90–97 (2006). https://doi.org/10.1007/s10096-006-0092-4

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