Epidemiology and Infection

The Hib immunization programme in the Oxford region: an analysis of the impact of vaccine administration on the incidence of disease

P. G. COEN a1c1, P. T. HEATH a2p1 and G. P. GARNETT a1
a1 Wellcome Trust for Epidemiology and Infectious Disease, Zoology Department, Oxford University, South Parks Road, Oxford OX1 3PS
a2 Oxford Vaccine Group, Department of Paediatrics, John Radcliffe Hospital, Oxford OX3 9DU


In May 1991 an immunization programme against Haemophilus influenzae type b (Hib) infection began within the Oxford region. We validate a deterministic mathematical model of Hib by comparison with the incidence of disease in the Oxford region, 1985–97. The comparison of model results with observed outcome allows an exploration of some of the poorly understood properties of the immunization programme. Model results and observed incidence are consistent with a vaccine that blocks the acquisition of carriage. Similarly, the data suggest that factors other than experience of Hib carriage are likely to have generated acquired immunity to Hib disease prior to the introduction of vaccination. Hence it is unlikely that waning of vaccine-derived protection will result in a resurgence of disease. The inclusion in the immunization schedule of a booster dose, as used in other countries, would have provided very little extra benefit.

(Accepted July 23 1999)

c1 Author for correspondence: Centre for Tropical Veterinary Medicine, Easter Bush, Roslin, Edinburgh EH25 9RG, Scotland, UK.
p1 Current address: Department of Child Health, St George's Hospital Medical School and St George's Vaccine Institute, Tooting, London SW17 0RE.