Regional hemophilus influenzae type B immunization program: A success or a false sense of security?

Objectives: Assessment of the hemophilus influenzae type B (Hib) immunization program in our institution. Design: Comparing the change in the incidence of Hib meningitis with the Hib immunization program. Setting: Saudi Aramco Al Hasa Health Center, Kingdom of Saudi Arabia. Subjects: All 16 cases of Hib meningitis diagnosed between January 1983 and October 1995. Interventions: Institution of Hib immunization program. Main outcome measures: Incidence of Hib meningitis after the institution of the immunization program. Results: Eight cases occurred before the Hib immunization program and all survived. Three developed sequellae which included hydrocephalus, cerebral atrophy, transient seizures and sensorineural hearing loss. Eight cases occurred after the Hib immunization program and all survived without severe sequellae. All these 16 infants were non- or incompletely immunized in dispensaries outside Saudi Aramco, where Hib immunization is not offered. No child fully immunized with Hib had Hib meningitis, or any other systemic Hib infection. Conclusions: The efficacy of Hib immunization in preventing invasive Hib infections in infancy and childhood is highlighted as well as the vulnerability of non-immunized infants. The only realistic and long-term solution to protect all children is to have the Ministry of Health implement a compulsory nation-wide Hib immunization campaign.