PEDIATRICS Vol. 82 No. 4 October 1988, pp. 571-575
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Haemophilus influenzae Type b Immunization of Children With Sickle Cell Diseases

Arthur L. Frank MD1, Richard J. Labotka MD1, Sudha Rao MD1, Lisa R. Frisone RN1, Patrick H. McVerry PhD1, Joel S. Samuelson MD1, Helen Maurer MD1, and Ram Yogev MD1

1 From the Departments of Pediatrics, University of Illinois College of Medicine, Cook County Hospital and Northwestern University Medical School, Chicago, and Connaught Laboratories, Swiftwater, Pennsylvania

Haemophilus influenzae type B vaccine is recommended for children 1.5 to 6 years of age with sickle cell anemia, but the adequacy of their response is unknown. A total of 69 children with sickle cell syndromes, 1.5 to 5.6 years of age, were immunized with two vaccines alternately, single blind PRP vaccine was given to 36 children and a diphtheria toxoid conjugated vaccine, PRP-D, was given to 36. Coded pre- and postvaccine sera were tested by radioimmunoassay for anti-PRP antibody. The groups did not differ in age distribution or type of sickle hemoglobinopathy. Preexisting antibody levels were low in both vaccine groups; 65% were <0.15 µg/mL. The vaccines were safe but associated with frequent minor reactions. PRP-D gave higher geometric mean titers and mean fold titer increase than PRP in all children (15.58 µg/mL [234-fold] v 2.63 µg/mL [29-fold]) and in the subgroups 1.5 to 2.5 years of age or with pretiter values <0.15 µg/mL. Titers for 64% of children receiving PRP and 94% receiving PRP-D were ge1.0 µg/mL. Thus, both vaccines were useful in this population, but PRP-D was more immunogenic. Duration of antibody levels postvaccination, booster responses, and PRP-D immunogenicity in younger children with sickle cell syndromes all require further study.

Key Words: Haemophilus influenzae type b • Sickle cell disease • conjugate vaccine • polysaccharide antigen • immune response

Submitted on August 17, 1987
Accepted on November 18, 1987




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