Pedvaxhib

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  • Vaccines

Pedvaxhib Generic Name & Formulations

General Description

Haemophilus b conjugate 7.5mcg (meningococcal protein conjugate 125mcg); per 0.5mL; susp for IM inj; contains aluminum.

Pharmacological Class

Hib (PRP-OMP).

How Supplied

Single-dose vials—10

Storage

  • Store vaccine at 2-8C (36-46F). Do not freeze.

Manufacturer

Generic Availability

NO

Mechanism of Action

An important virulence factor of the Hib bacterium is its polysaccharide capsule (PRP). Antibody to PRP (anti-PRP) has been shown to correlate with protection against Hib disease.While the anti-PRP level associated with protection using conjugated vaccines has not yet been determined, the level of anti-PRP associated with protection in studies using bacterial polysaccharide immune globulin or nonconjugated PRP vaccines ranged from >0.15–>1.0mcg/mL.

Pedvaxhib Indications

Indications

Immunization of children against H. influenzae type b.

Pedvaxhib Dosage and Administration

Adult

Not recommended.

Children

<2 months or ≥6yrs: not recommended. 2–14 months: give 2 doses of 0.5mL IM, separated 2 months apart (begin ideally at 2 months of age). Children vaccinated (with 2 dose regimen) before 12 months of age should receive booster at 12–15 months of age (but not <2 months after previous shot). Previously unvaccinated children, 15–71 months: 0.5mL lM once.

Pedvaxhib Contraindications

Not Applicable

Pedvaxhib Boxed Warnings

Not Applicable

Pedvaxhib Warnings/Precautions

Warnings/Precautions

May be interchanged with other licensed Haemophilus b Conjugate Vaccines for primary and booster doses. Have epinephrine inj (1:1000) available. Delay administration in febrile or active infection. Immunocompromised. Malignancies. Protection begins several days after inj. Latex allergy. Pregnancy.

Warnings/Precautions

  • Have epinephrine available for immediate use if an anaphylactoid reaction occurs.

  • Use caution in latex-sensitive individuals.

  • Use special care to not administer the injection into a blood vessel.

  • Use a separate sterile syringe and needle for each patient.

  • PedvaxHIB may not induce protective antibody levels immediately following vaccination.

  • Prior to the onset of the protective effects of the vaccines, cases of Hib disease may occur in the week after vaccination.

  • If an individual has a current or recent febrile illness, the decision to administer or delay vaccination should be based on the severity of symptoms and on the etiology of the disease. The ACIP recommends delaying vaccination during an acute febrile illness. 

  • Individuals with minor illnesses (eg, diarrhea, mild URTI with or without low-grade fever, or other low-grade febrile illness) can be vaccinated.

  • Individuals with moderate or severe febrile illness may be vaccinated as soon as they recover from the acute phase of the illness.

  • May receive suboptimal immune responses in individuals with malignancies or those receiving immunosuppressive therapy or are otherwise immunocompromised.

Pregnancy Considerations

Studies have not been conducted with PedvaxHIB.

Pediatric Considerations

Safety and efficacy of PedvaxHIB has not been established in infants below 2 months of age and in children 6 years of age and older.

Do not use Liquid PedvaxHIB in infants younger than 6 weeks of age due to a reduced anti-PRP response. Do not use Liquid PedvaxHIB in individuals 6 years of age and older.

Geriatric Considerations

Not recommended for use in adult populations.

 

Pedvaxhib Pharmacokinetics

See Literature

Pedvaxhib Interactions

Interactions

Concomitant immunosuppressants: may get suboptimal responses. 

Pedvaxhib Adverse Reactions

Adverse Reactions

Local reactions, fever.

Adverse Reactions

Post-Marketing Adverse Reactions

  • Hemic and Lymphatic System: Lymphadenopathy.

  • Hypersensitivity: Angioedema (rarely).

  • Nervous System: Febrile seizures.

  • Skin: Sterile injection site abscess.

Pedvaxhib Clinical Trials

Clinical Trials

Clinical Evaluation of PedvaxHIB – The Protective Efficacy Study

  • In a randomized, double-blind, placebo-controlled study, the lyophilized formulation of PedvaxHIB was evaluated in 3486 Native American (Navajo) infants who completed the primary 2-dose regimen. Patients were randomly assigned to receive either 2 doses of PedvaxHIB or placebo with the first dose being at a mean of 8 weeks of age and the second dose administered approximately 2 months later; DTP and OPV were administered concomitantly.

  • After a follow-up until 15 to 18 months of age, there was only 1 case of invasive Hib disease in the vaccine group and 22 cases in the vaccine group. The protective efficacy of lyophilized PedvaxHIB was calculated to be 93% (95% CI, 57-98; P =.001, two-tailed). In the time between the first and second doses, there were 0 cases in the vaccine group and 8 cases in the placebo group (P =.008, two-tailed).

  • At the end of the study, patients in the placebo group were offered the vaccine and all patients were then followed for 2 years and 9 months. In the follow-up period, the estimated efficacy from person-days at risk was 96.6% (95% CI, 72.2-99.9) in children under 18 months of age and 100% (95% CI, 23.5-100) in children over 18 months of age).

Other Clinical Studies

  • Safety and immunogenicity of lyophilized PedvaxHIB was evaluated in infants and children in studies conducted throughout the US. All age groups who received PedvaxHIB were found to be highly immunogenic.

  • Among poor responders to nonconjugated PRP vaccines, lyophilized PedvaxHIB elicited antibody levels greater than 1.0 mcg/mL in children. 

  • Another study included 34 children aged 27 to 61 months who developed invasive Hib disease despite previous vaccination with nonconjugated PRP vaccines. These children were randomly assigned to receive either lyophilized PedvaxHIB or a nonconjugated PRP vaccine at approximately 12 months after recovery from the disease. The antibody level of >1.0 mcg/mL was achieved by all children who receive PedvaxHIB vs 6 out of 20 children revaccinated with a nonconjugated PRP vaccine.

  • PevaxHIB was also evaluated in children at high risk of Hib disease due to genetically-related deficiencies (Blacks who were Km(1) allotype negative and Caucasians who were G2m(23) allotype negative) and are considered hyporesponsive to nonconjugated PRP vaccines on this basis. All children vaccinated with lyophilized PedvaxHIB achieved anti-PRP levels of >1.0 mcg/mL.

Clinical Study – Liquid PedvaxHIB vs Lyophilized PedvaxHIB 

  • In a randomized clinical study, 903 infants 2 to 6 months of age received either Liquid PedvaxHIB or lyophilized PedvaxHIB; DTP and OPV were administered concomitantly to most patients. Each formulation elicited similar antibody responses.

Interchangeability of Licensed Haemophilus b Conjugate Vaccines and PedvaxHIB 

  • Published studies have shown that if PedvaxHIB is administered with other licensed Haemophilus b Conjugate Vaccines, the recommended number of doses to complete the series is determined by the other product and not by PedvaxHIB. PedvaxHIB may be interchanged with other licensed vaccines for the booster dose.

Use with Other Vaccines

  • Clinical studies have shown that Liquid PedvaxHIB can be administered concomitantly with DTP, OPV, eIPV, Varivax, M-M-R II, or Recombivax HB.

Pedvaxhib Note

Not Applicable

Pedvaxhib Patient Counseling

Patient Counseling

Inform patient, parent, or guardian of the benefits and risks associated with vaccination.

Report any serious adverse reactions to their health care provider who should then report such events to the Vaccine Adverse Event Reporting System (VAERS) at 1-800-822-7967.