Hib Vaccines

Haemophilus influenzae type b (Hib) is a bacterium which can lead to serious, often life-threatening illness in young children. Hib causes meningitis and severe pneumonia, leading to an estimated 3 million cases of serious illness and 400,000 deaths each year in children under 5 years of age.

There is a highly safe and effective vaccine routinely used in the industrialized world for over 15 years.  More than 100 countries, including Canada, the United States, Australia, New Zealand, and many countries in Western Europe routinely use Hib vaccines in childhood immunization programmes and have documented virtual elimination of Hib disease.

WHO recommends that Hib vaccine be included in all countries’ routine infant immunization programs and funding from the GAVI Alliance is available to introduce the vaccine into resource-constrained countries.  Currently, 61 of 72 countries eligible for GAVI funding have introduced or will introduce Hib vaccine into their routine immunization program by 2009.

Hib Vaccine Supply and Financing

The status of vaccine supply and financing for Hib-containing vaccines has improved considerably in recent years.

Supply is currently available in sufficient quantities to meet the needs of both low and middle income countries.  New, pre-qualified products from emerging country manufacturers are also expected soon.

GAVI phase 2 financing allows GAVI-eligible countries to purchase the vaccine for a small co-payment through 2015.  Many middle-income countries have also recently been able to adopt Hib-containing vaccines. However, others, particularly lower middle income countries, are struggling to find affordable solutions for Hib vaccine use.  As more countries move towards adopting of pentavalent vaccines, the market demand is becoming more predictable.  This may encourage additional suppliers to enter the market, leading a decline in vaccine prices. Nonetheless, lower middle income countries urgently need strategies to access Hib-containing vaccines.

Global vaccine supply and demand

Uptake for Hib-containing vaccines has increased rapidly since 2007-2008 and is expected to continue in both low and middle income countries. Forecasted demand for Hib-containing vaccine is expected to exceed 100 million doses in GAVI-eligible countries in 2009.  Long-term predictions indicate that demand in lower and middle income markets will peak at nearly 350 million doses in the timeframe of 2015 to 2017.

In the next couple of years, there will likely be increased demand for liquid formulations of pentavalent vaccines, with sufficient capacity to meet that demand.

Hib-containing Vaccines: Products Currently Available and In Development

Currently, there are a large number of vaccine manufacturers producing and developing Hib-containing vaccines. For GAVI-eligible countries, suppliers produce pentavalent, monovalent and tetravalent Hib-containing vaccines. The UNICEF supply division maintains current lists of available UNICEF-procured vaccines on their website.

Qualifying and distributing vaccines

The global community is working to ensure a sustainable and affordable supply of Hib vaccines. Increased competition among manufacturers and additional demand for the easy-to-use combination vaccines promise an adequate supply of the vaccine in the years to come.

The UNICEF Supply Division is responsible for procuring vaccines and devices for countries on behalf of the GAVI Alliance. The World Health Organization provides a “pre-qualification” service to UNICEF and other UN agencies by assessing the quality, safety and efficacy of vaccines from a variety of different sources. 

A list of WHO pre-qualified vaccines is available here.

Financing Hib Vaccines through the GAVI Alliance

The GAVI Fund enables eligible* countries to purchase Hib containing vaccine for a small co-pay of 15 to 30 cents per dose. Additional vaccines can also be adopted for a co-payment of 15 cents per dose.  GAVI pays for the remainder of the vaccine cost, which is often procured through UNICEF. Countries are eligible for funding through 2015, provided that the vaccine is included in their Comprehensive Multi-Year Plan (cMYP).

GAVI Phase 2 has extended funding to allow more countries to provide children with lifesaving vaccines. The increase in predictable demand is already drawing more manufacturers.  Prices of pentavalent combinations are expected to decline, making vaccines increasingly more affordable.