This study describes the long-term complications in children with Haemophilus influenzae serotype b (Hib) vaccine failure and to determine their risk of other serious
infections. The families of 323 children with invasive Hib disease after appropriate vaccination (i.e.
vaccine failure) were contacted to complete a questionnaire relating to their health and 260 (80.5%) completed the questionnaire. Of the 124 children with
meningitis, 18.5% reported serious long-term sequelae and a further 12.1% of parents attributed other problems to Hib
meningitis. Overall, 14% (32/231 cases) of otherwise healthy children and 59% (17/29 cases) of children with an underlying condition developed at least one other serious
infection requiring hospital admission. In a Poisson regression model, the risk of another serious
infection was independently associated with the presence of an underlying medical condition (incidence risk ratio (
IRR) 7.6, 95% CI 4.8-12.1; p<0.0001), both parents having had a serious
infection (
IRR 4.1, 95% CI 1.6-10.3; p=0.003), requirement of more than two
antibiotic courses per year (
IRR 2.3, 95% CI 1.4-3.6; p=0.001) and the presence of a long-term complication after
Hib infection (
IRR 1.8, 95% CI 1.1-3.1; p=0.03). Thus, rates of long-term sequelae in children with
vaccine failure who developed Hib
meningitis are similar to those in unvaccinated children in the pre-
vaccine era. One in seven otherwise healthy children (14%) with Hib vaccine failure will go on to suffer another serious
infection requiring hospital admission in childhood, which is higher than would be expected for the UK paediatric population.