These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.
Question: Please, could you help me in clarification of the following (Act-HIB (PRP-T) vaccine related) case:
My daughter experienced serious invasive Haemophilus influenza type b infection (manifested as serious meningitis accompanied by septicemia) when she was 14 months old. Disease was successfully treated in a specialized hospital (10 days of intensive care, all together 6 weeks) with a result -> fully recovered without evidence of neurologic sequelae (blood tests - normal, EEG - normal, CT - normal ... )! Immunization against Hib is NOT a routine one in Croatia (Europe) where we live! My daughter received a first dose of Act-HIB vaccine (produced/distributed by Institute Merieux GmbH, 69181 Leimen) after she recovered from disease, when she was 15 months old! One month after immunization, blood test was performed with result: 'Antibody to the Hib - IgG negative'! Second immunization with same vaccine type (Act-HIB) was performed two months after first one (when she was 17 months old)! Blood test results, one and two months after second dose, were the same again ('antibody to the Hib - IgG negative'). Third dose of the same vaccine (Act-HIB) was administered 3 months after second one (when she was 20 months old). Blood test result, two month after third dose, was again the same ('antibody to the Hib - IgG negative')! Before and after a mentioned Hib disease my daughter has not had any other serious disease (few times she got cold only)! She is a normal, healthy two years old child now (94 cm, 16 kg, she already talks a lot ...)!
Q1 . Is it possible that Act-HIB (PRP-T) vaccine did not induce antibody production (what could be a possible explanation)?
Q2. Are there any adverse reactions (health problems) related to the applied immunization (Act-HIB) schedule (at age 15,17 and 20 months)?
Q3. What are the recommended tests to proof immunity (against Hib) after the immunization with Act-HIB vaccine (is a blood test 'IgG - antibody to the Hib' correct one)?
Q4. Which tests/examinations to be performed in the future (to clarify whole case)? Answers to the questions will help me (and our physician) a lot (hospital, where was may daughter treated, has not enough experience with Hib immunization because in Croatia this is not a routine one)!
Answer: Any of the vaccines has a certain percentage of failure to sero convert-your daughter is obviously one. There should be no adverse reactions due to the multiple immunizations-if not seen immediately. I would check further into her immune status. Haemophilus Influenze is a encapsulated organism and there are certain specific defects (immune defects) that prevent white blood cells from attacking encapsulated organisms. However, I am not aware of any reason why she should not develop antibodies in this syndrome. I would have a clinical immunologist test her system-this involves several specific tests of white blood cell function.
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