Gessner Bradford D
Agence de Médecine Préventive, 25 rue du Dr Roux, 75724 Paris cedex 15, France.
Expert Rev Vaccines. 2009 Jan;8(1):91-102. doi: 10.1586/14760584.8.1.91.
The Haemophilus influenzae type b (Hib) conjugate vaccine has been administered for almost 20 years in developed countries with remarkable success. More recently, the vaccine has been introduced in resource-poor settings, mainly those in Africa. African countries have documented large declines in Hib-invasive disease following universal vaccine introduction based on evaluation of routine surveillance data. As of 2007, only Mongolia in Asia had introduced the vaccine. Consequently, studies are limited to clinical trials in Bangladesh and Indonesia, and these also demonstrate substantial vaccine impact. Beyond invasive disease, three pivotal trials in Africa and Asia have demonstrated vaccine impact against clinical pneumonia end points. In all settings evaluated, Hib vaccine was shown to be cost effective, although the vaccine is not yet cost saving based on pentavalent vaccine prices in excess of US$3 per dose. Future issues include monitoring for serotype replacement and the effects of the HIV epidemic, evaluating the usefulness of a booster dose or new vaccine schedules and working to lower vaccine prices.
b型流感嗜血杆菌（Hib）结合疫苗在发达国家已应用近20年，取得了显著成效。最近，该疫苗已在资源匮乏地区引入，主要是非洲的一些地区。根据常规监测数据评估，非洲国家在普遍引入疫苗后，Hib侵袭性疾病大幅下降。截至2007年，亚洲只有蒙古引入了该疫苗。因此，相关研究仅限于在孟加拉国和印度尼西亚进行的临床试验，这些试验也证明了疫苗的显著效果。除了侵袭性疾病，在非洲和亚洲进行的三项关键试验证明了疫苗对临床肺炎终点的影响。在所有评估的环境中，Hib疫苗被证明具有成本效益，尽管根据每剂超过3美元的五价疫苗价格，该疫苗尚未节省成本。未来的问题包括监测血清型替换和艾滋病毒流行的影响，评估加强剂量或新疫苗接种程序的效用，并努力降低疫苗价格。
