As I enjoyed my morning coffee, I found myself musing about why vaccine hesitancy has established such a presence in our society. “Don’t they remember how bad it was before vaccines?” I wondered aloud. Then I realized that most people don’t remember. Many of the diseases that we vaccinate against have been under control for several decades in this country. But those pathogens are still here, and I do remember how bad it was. In this blog series I am going to refresh our memories on some of these diseases.
Let’s start with Haemophilus influenzae type B,. a gram negative coccobacillary bacterium. Hib still screams at me and haunts my nightmares. I recollect seeing at least one case a month of critical Haemophilus influenzae type B disease. These Hib cases presented as primarily meningitis, but also sepsis, pneumonia, epiglottitis, peri orbital cellulitis, and pericarditis. I remember sitting up nights in the ICU trying to stabilize blood pressure, seizures, and vitals while waiting for antibiotics to take effect. Thanks to antibiotics, some of the patients survived, but many of those patients had long term complications. Some meningitis patients were left with permanent neurologic impairments. One of my patients with pericarditis, a precious 2-year-old child, was minutes away from dying when he came to us. His heart was unable to pump because it was constricted by the pus in the sac surrounding it. An immediate surgery stabilized him, but he later required a second surgery. He was able to go home after 3 weeks, but was still facing weeks of antibiotic treatment.
I was ecstatic when my own children reached 15 months, the earliest a child could get the vaccine for Hib at the time. I knew this was one devil I would no longer have to worry about. Now, through immunization, a child can be fully protected from Haemophilus influenzae type B by 6 months of age.
Though we have antibiotics to treat Hib, we have the ability to protect from this devastating pathogen through immunization. Hib vaccines dramatically reduce both the presence of active disease and future colonization, thus providing direct protection and some herd immunity. Think it’s okay to delay immunization since there are antibiotics to treat the disease? Think again. Antibiotic resistance to Haemophilus influenzae type B has emerged as a major obstacle in treatment in countries with poor vaccination rates. We are now faced with the possibility that only the strongest, and potentially the most toxic, antibiotics will control this pathogen. Prevention is a far better course of action.
More information about Haemophilus influenzae Type B (Hib)
- Haemophilus influenzae | Home | Hib | CDC
- Hib Disease (Haemophilus Influenzae Type b) (for Parents) – Nemours KidsHealth
- A Look at Each Vaccine: Haemophilus Influenzae Type B (Hib) Vaccine | Children’s Hospital of Philadelphia (chop.edu)
About the Author: Susan McGrew, MD
After graduating from Northwestern University Medical School in 1981, Dr. Susan McGrew entered a pediatrics residency at Vanderbilt University Medical Center. Dr. McGrew then practiced general pediatrics in Nashville for 10 years before returning to Vanderbilt to specialize in Autism until her retirement in 2011.