Volume 4 Supplement 1

3rd Pediatric Allergy and Asthma Meeting (PAAM)

Open Access

P13 - Vaccination against Haemophilus B as a treatment of recurrent upper respiratory tract infections

  • Chrys Tsakona1
Clinical and Translational Allergy20144(Suppl 1):P68

https://doi.org/10.1186/2045-7022-4-S1-P68

Published: 28 February 2014

Haemophilus influenza b (Hib) conjugate vaccines are highly immunogenic in infants, as >95% develop protective antibody levels after 2 or 3 doses; hence invasive Hib disease is now uncommon in vaccinated children. The precise protective level is not clearly established, although a titre of 1 μg/mL is considered to offer long-term protection. Hib vaccination above the age of 5 is not recommended; the majority of older even unvaccinated children seem to be immune to Hib, probably from asymptomatic infections in infancy. The vaccine though is used in any age as a functional assay of the responsiveness of the immune system to capsular polysaccharide antigens, We present 3 children with recurrent upper respiratory tract infections where the test vaccine has also acted in a therapeutic manner.

1) A 6 yr old boy was referred to us for urticaria. His mother mentioned frequent “colds” requiring antibiotics several times a year. His serum Immunoglobulins and routine investigations were normal/negative except for the functional Hib antibody levels which were suboptimal at 0.22 μg/mL rising to >10 μg/mL 4 weeks post-vaccination, when the recurrent infections stopped.

2) Another 6 yr old was referred with eczema and the mother mentioned that he had been investigated inconclusively for unexplained lethargy. He was blowing green mucus from his “constantly blocked nose”; his functional Hib antibody levels were suboptimal at <0.15 rising eventually to 1.7 μg/mL after 3 vaccinations, which stopped the subclinical sinusitis and of course the lethargy.

3) A third child was seen for nut allergy. He missed his follow-up appointments for 18 months because he was constantly having respiratory infections, which caused bronchiectasis. A sputum sample at the time of the diagnosis grew Haemophilus (not typed) and started prophylactic antibiotics. A blood test a month later showed suboptimal levels of functional antibody and subsequently excellent response to the vaccination; the infections stopped, although one could argue this was an effect of the prophylactic antibiotics.

Our relevant adult and paediatric data is currently being studied and processed as this is a new therapeutic aspect.

Authors’ Affiliations

(1)
Dudley Group of Hospitals NHS Foundation Trust

Copyright

© Tsakona; licensee BioMed Central Ltd. 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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