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CONFLICTING DATA ON EFFICACY OF HAEMOPHILUS B VACCINE.

The polysaccharide vaccine against Haemophilus b, first licensed in the United States in 1985, was shown to be effective in Finnish children and to induce antibody formation in children here. It was expected that the vaccine would also be found effective in this country but, as is dramatically demonstrated by three retrospective case- control studies in JAMA, its efficacy remains unclear.

All three studies compared vaccination rates among children with Haemophilus infection and uninfected controls. Shapiro's group concluded that the vaccine was 88 percent effective, Harrison's group reported 45 percent efficacy, and Osterholm's group found that the vaccine was not effective and even enhanced the risk of invasive infection.

In an accompanying editorial, Mortimer speculates that the cause of these conflicting results is not methodology, but biological variation in Haemophilus b strains around the country. He expects that the newly licensed conjugate vaccine, which is thought to be more immunogenic, will provide more protection than the vaccine currently in use.

Another study in the same issue reports a cluster of Haemophilus infections among nursing home patients, suggesting that the elderly may be more susceptible to such infections than was previously realized.

— THL

Published in Journal Watch General Medicine September 13, 1988

Citation(s):

Mortimer E A, Jr. Efficacy of Haemophilus b polysaccharide vaccine: an enigma. JAMA 1988 Sep 9 260 1454-1455.

• Medline abstract (Free)

Smith P F; Stricof R L; Shayegani M; Morse D L. Cluster of Haemophilus influenzae type b infections in adults. JAMA 1988 Sep 9 260 1446-1449.

• Medline abstract (Free)

Osterholm M T; Rambeck J H; White K E et al. Lack of efficacy of Haemophilus b polysaccharide vaccine in Minnesota. JAMA 1988 Sep 9 260 1423-1418.

• Medline abstract (Free)

Shapiro E D; Murphy T V; Wald E R; Brady C A. The protective efficacy of Haemophilus b polysaccharide vaccine. JAMA 1988 Sep 9 260 1419-1422.

• Medline abstract (Free)

Harrison L H; Broome C V; Hightower A W et al. A day care-based study of the efficacy of Haemophilus b polysaccharide vaccine. JAMA 1988 Sep 9 260 1413-1418.

• Medline abstract (Free)

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