Friday, April 11, 2014

Vaccines: HIB

   I was inspired to write this series of posts after reading The Vaccine Book by my Dr. Sears. All information in these posts is basically a summary of the information written in the book.

     Vaccines are such a hot topic. Some families vaccinate religiously, some adamantly refuse to, and both sides have excellent and (most of the time) well researched arguments. As a mother, I knew I wanted to have my children vaccinated but I wan't exactly sure why. I realized I didn't even know what diseases we vaccinate for, what ingredients were controversial and what the possible side effects were. I realized that without knowing it, I was leery of certain vaccines that I didn't see as absolutely necessary; I had never had a flu shot and I elected to opt out of the trendy new HPV vaccines that came out when I was a teenager. For some reason they made me nervous.
     The point of these posts is to present a little more information about vaccines, diseases they hope to prevent, and their potential side effects. Working as an ER nurse, I am used to breaking down tons of information and presenting it to patients into small, workable chunks that make sense and they will remember. I hope this is what I have done here. 

HIB: Haemophilus Influenzae Type B
>Given at 2, 4, 6 and 15 months of age. 

HIB is a bacteria exclusive to infants and the elderly that is passed like the common cold. The HIB bacteria can cause:
          Meningitis- an infection of the lining of the brain
          Blood Infections
          Bone Infections
          Epiglottitis- an infection of the epiglottis in the throat than can obstruct breathing
          Pneumonia- an infection causing fluid to build up in the lungs

Signs and symptoms of infection with HIB:
Mild infections caused by HIB present like a cold. A fever that does not resolve on it's own after a few days would prompt a trip to the pediatrician, who would treat with antibiotics if symptoms of ear or sinus infection, bronchitis or possible pneumonia are present. Usually the antibiotics will treat the illness without ever being discovered as HIB. 
Moderate infections begin like a mild infection does, but the child will also appear lethargic, may have labored breathing and will "look sick" enough to call for a chest X-ray, blood work and oral antibiotics.  The blood cultures are positive for HIB (that take 48 hours to result), and the parents of the child will be called to have the child come to the hospital for several days of IV antibiotics.
Severe infections with HIB will present with meningitis symptoms, severe pneumonia symptoms or epiglottitis which the treating doctor will immediately recognize. The child would be immediately admitted to the hospital for several days of IV antibiotics and possibly respiratory support via endotracheal intubation in an intensive care unit. Most children with severe HIB infections recover, but slowly, and about 25% will have permanent effects such as hearing loss, learning difficulty or nerve injury. Fatality is 5%. 

~Before the HIB vaccine in the 80's, incidence of HIB infections per year in the US was about 20,000 cases. Now there are only about 25 per year, but remember, these are only the more serious cases that are evident enough to call for blood work and be positively diagnosed and treated as HIB. 

~The HIB vaccine is made by using the sugars that coat the outside of the bacteria and are added to the vaccine solution. The vaccine does not contain full or living HIB bacteria, so there is no chance of infection by HIB from the vaccine. 

Potentially Harmful Ingredients

  • Two brands of HIB vaccine, ActHIB and Hiberix, contain formaldehyde, a known carcinogen, in very tiny amounts (less than 0.5 micrograms). 
  • The PedVaxHIB brand contains 225 micrograms of aluminum. Toxic effects of aluminum can occur if too many aluminum containing vaccines are given at one time. In the book, Dr. Sears includes an alternate vaccine schedule which you can find here, on another page of this blog that I copied out of the book. 
Common Side Effects

  • Local redness, swelling and pain at injection site (25% of kids), moderate to high fever (5%). There are no known severe reactions. Post market surveillance reveals that the vaccine can also cause swollen lymph nodes, sterile abscess at injection site, swelling of injected limb, allergic reaction, seizures, a shock-like reaction, sleepiness, apnea (a period of no breathing) hives and rash. 

Dr. Sears' Summary: "HIB is a bad bug. Fortunately, it is also a rare bug, so rare that I have not seen a single case in my practice. Ongoing use of this vaccine in our country helps keep it away. The HIB vaccine is one of the safest we have. The ingredients aren't too strange and the known side effects are uncommon. Since the disease is so rare, HIB isn't the most critical vaccine. But its definitely high on the list." 

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