A Look at Each Vaccine: Haemophilus Influenzae Type B (Hib) Vaccine

Older pediatricians understand the value of the Haemophilus influenzae type b vaccine. They watched this vaccine, first introduced in the early 1990s, virtually eliminate a disease that affected about 25,000 children every year in the United States. The vaccine is recommended for all children between 2 and 15 months of age.

  • The disease

    What is Haemophilus influenzae type b?

    Haemophilus influenzae type b (Hib) is a bacterium that infects the lining of the brain, causing meningitis. Meningitis is caused by several different bacteria. However, before the Hib vaccine, Hib was by far the most common cause of meningitis. Children with meningitis often have fever, stiff neck and drowsiness. Symptoms can progress to include coma and death. Some children recover from the disease but are left permanently paralyzed, deaf, blind or mentally impaired. Hib can also cause bloodstream infection (sepsis), pneumonia, cellulitis, arthritis and epiglottitis. Perhaps no disease was more frightening than this last one. The epiglottis, a membrane that sits on top of the windpipe, prevents food from entering the windpipe when swallowing. When the epiglottis is infected, it occludes the windpipe, causing suffocation and occasionally death.

    How do you catch Hib?

    Hib is a bacterium that is commonly found lining the surface of the nose and the back of the throat. Many children will come in contact with Hib sometime in the first two years of life. Because most adults have immunity to Hib, a mother will passively transfer antibodies from her own blood to the blood of her newborn baby before the baby is born. The antibodies that the baby gets before birth usually last for a few months. However, after that time, the baby is unprotected. Most children who first come in contact with Hib don't have a problem. But before the Hib vaccine, about 25,000 children every year would get serious and occasionally fatal infections with Hib. Most children harmed by Hib were previously healthy and well nourished.

  • The vaccine

    How is the Hib vaccine made?

    The Hib vaccine is made from the sugar coating (polysaccharide) of the bacteria. Antibodies directed against the Hib polysaccharide protect the child against an infection that could result in permanent disabilities or death.

    Unfortunately, children less than 2 years old don't develop very good immune responses to this polysaccharide, even if exposed to it through infection. For this reason, children less than 2 years old who catch Hib and survive the infection are still recommended to receive the Hib vaccine.

    Scientists have figured out that by taking the Hib polysaccharide and linking it to a harmless protein, young children are able to make a stronger immune response to the polysaccharide. This “conjugated” version of the Hib vaccine works extremely well. Before the vaccine, Hib caused about 25,000 cases of serious disease in the United States every year. In 2012, fewer than 25 cases of Hib in children 5 years of age and younger were reported to the Centers for Disease Control and Prevention (CDC).

    What are the side effects of the Hib vaccine?

    After receiving the Hib vaccine, some children may feel pain or soreness in the local area of the shot and occasionally get a low-grade fever. The Hib vaccine does not cause serious side effects.

  • Other questions you might have

    Is it true that more than one infection can cause meningitis?

    Yes. Everyone has heard it on the news—the story of a local student infected with meningitis. Such a report inevitably results in many questions and a great amount of concern and even fear among families with children in the affected school.

    There are some important considerations when this happens. First, it is important to remember that meningitis refers to an infection that has reached the lining of the brain and spinal cord. Second, it can be caused by viruses or bacteria (hence the terms viral meningitis or bacterial meningitis). 

    Viral meningitis is often less severe than bacterial meningitis. Most, but not all, cases of bacterial meningitis can be prevented by vaccination. The bacteria most often associated with meningitis include meningococcus, pneumococcus, and Haemophilus influenzae type B (often referred to as Hib). Fortunately, by the age of 2, most children are fully immunized against pneumococcus and Hib and most adolescents are protected against meningococcus.


    Other diseases caused by Hib include:

    • Sepsis (bloodstream infection)
    • Epiglottitis (severe swelling of the epiglottis, a tissue that closes off the windpipe during swallowing)
    • Arthritis (infection of the joints)
    • Pneumonia (infection of the lungs)
    • Cellulitis (most commonly involving the side of the cheek, called buccal cellulitis)
  • Relative risks and benefits

    Do the benefits of the Hib vaccine outweigh its risks?

    The Hib vaccine has caused a dramatic decline in the incidence of meningitis, bloodstream infections, and pneumonia caused by Hib. However, Hib bacteria still circulate in the community and occasionally cause disease. Unfortunately, because of vaccine safety concerns, some parents have refused the Hib vaccine for their children, and in 2009, four children died as a result.

    On the other hand, the Hib vaccine causes no serious side effects. Therefore, the benefits of the Hib vaccine clearly outweigh its risks.

    Disease risks

    • Meningitis (fever, stiff neck, drowsiness; in a small number of cases coma)
    • Sepsis (bloodstream infection)
    • Epiglottitis (severe swelling of the epiglottis, a tissue that closes off the windpipe during swallowing)
    • Arthritis (infection of the joints)
    • Cellulitis (a skin infection)
    • Pneumonia (infection of the lungs)
    • Disease can be fatal

    Vaccine risks

    • Pain or soreness at the injection site
    • Low-grade fever
  • Reference

    Plotkin SA, Orenstein W, and Offit PA. Haemophilus influenzae vaccines in Vaccines, 6th Edition. 2012, 167-182.

Reviewed by Paul A. Offit, MD on August 18, 2014

Materials in this section are updated as new information and vaccines become available. The Vaccine Education Center staff regularly reviews materials for accuracy.

You should not consider the information in this site to be specific, professional medical advice for your personal health or for your family's personal health. You should not use it to replace any relationship with a physician or other qualified healthcare professional. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult your physician or, in serious cases, seek immediate assistance from emergency personnel.