When Should Your Child Receive the Third Dose of Hib Vaccine?

When should the Haemophilus influenzae type b (Hib) vaccine be administered, and which dose is recommended?

Hello, Dr.
Pei! My child is currently 11 months old.
He received the "DTaP-Hib-IPV" vaccine at 2 months, the "DTaP-Hib-IPV" vaccine again at 4 months, and the "DTaP-Hib-IPV" vaccine at 6 months.
It seems that he is missing the third dose of the Hib vaccine.
Should we wait until he turns 12 months to complete the varicella vaccine before administering the third dose of the Hib vaccine (is it necessary to wait one month?), or should we wait until he is over one year old to administer it along with the next dose of the DTaP-Hib-IPV vaccine? Is the third dose of the Hib vaccine needed then? (Will the previous doses become ineffective if there is such a long gap?) Or should we go ahead and administer the third dose of the Hib vaccine now? I have seen information online stating: "Infants under six months receive two doses of the vaccine at two and four months, with a booster at 12 to 15 months; infants aged seven to eleven months receive two doses spaced two months apart, with a booster at 12 to 18 months; children aged twelve to fourteen months receive two doses spaced two months apart; and children aged fifteen months to five years only need one dose." However, I am unsure about which doses these refer to.
Thank you for your response!

Finna, 30~39 year old female. Ask Date: 2006/03/29

Dr. Pei Rensheng reply Pediatrics

Currently, there are three pharmaceutical companies in the country that distribute different vaccines:
1.
Aventis (Maris Industrial) provides information on the ACT-HiB vaccine, which states: "For infants under six months, three doses of the vaccine should be administered at 1-2 month intervals.
A fourth dose should be given one year after the third dose, which can coincide with the basic vaccination schedule for diphtheria, pertussis, and tetanus.
For infants aged six to twelve months, two doses should be administered one month apart, followed by an additional dose at eighteen months.
For children aged one to five years, only one dose of the vaccine is required."
2.
SB (SmithKline Beecham) provides information on the Hiberix vaccine, which is similar to the information provided by Aventis (Maris Industrial) for the ACT-HiB vaccine.
3.
MSD (Merck) provides information on the PedvaxHIB vaccine, stating: "For infants aged two to fourteen months, the first dose should be followed by a second dose administered two months later.
If the second dose is completed before the infant turns twelve months, a third dose must be given between twelve to fifteen months of age; however, the third dose must be at least two months after the second dose.
For children over fifteen months, only one dose of the vaccine is required."
You may discuss with your physician the number of doses required based on the type of vaccine.
The Hib vaccine is an inactivated vaccine and can be administered simultaneously or at any interval with the live varicella vaccine.
If you are unsure whether multiple vaccines can be given together, it is generally safer to space them at least one month apart.

Sincerely, Dr.
Pei Ren-Sheng, Pediatrics.

Reply Date: 2006/03/29

More Info

When it comes to the administration of the Hib (Haemophilus influenzae type b) vaccine for your 11-month-old child, it's important to follow the recommended vaccination schedule to ensure optimal protection against infections caused by this bacterium. Based on the information provided, your child has already received the necessary vaccinations at 2 months and 4 months, but it appears that the third dose of the Hib vaccine is still pending.

According to the guidelines for Hib vaccination, children aged 7 to 11 months should receive two doses of the vaccine, spaced at least one month apart. After these two doses, a booster dose is typically recommended between 12 to 18 months of age. In your case, since your child is currently 11 months old, it would be advisable to administer the third dose of the Hib vaccine now rather than waiting until after the varicella (chickenpox) vaccine or until your child turns one year old.

The concern about the timing of vaccinations is valid, but it is important to note that the Hib vaccine is not rendered ineffective by a delay in administration. Vaccines are designed to provide immunity even if there are slight delays in the schedule. However, it is always best to adhere to the recommended vaccination schedule as closely as possible to ensure that your child is adequately protected against potential infections.

Regarding the specific question of whether to wait until after the varicella vaccine, it is generally acceptable to administer the Hib vaccine concurrently with other vaccines, including live vaccines like the varicella vaccine. However, if you prefer to space them out, it is recommended to wait at least one month between administering different vaccines, especially if they are from different manufacturers. This is primarily a precautionary measure to monitor for any potential adverse reactions.

In summary, you should consider administering the third dose of the Hib vaccine now, as your child is within the appropriate age range for this vaccination. This will help ensure that your child has the best possible protection against Hib infections. After the third dose, you can then plan for the varicella vaccine, keeping in mind the recommended spacing between vaccinations. Always consult with your pediatrician or healthcare provider for personalized advice and to confirm the best vaccination schedule for your child. They can provide guidance based on your child's health history and any other vaccinations that may be due.

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