A novel, and newly licensed hexavalent vaccine, comprising diphtheria, tetanus, acellular pertussis (DTaP), inactivated polio (IPV),  Haemophilus influenzae (Hib) and hepatitis b virus (HepB) vaccines, may allow for simpler administration of and adherence to infant vaccine series recommendations, according to results of a study presented at IDWeek 2019, held from October 2 to October 6, 2019 in Washington DC, Maryland.

Immunization schedules for infants in the United States delineate administration of doses of DTaP, IPV, Hib, and HepB within the first 6 months of life. These are commonly administered via a pentavalent combination of either DTaP-HepB-IPV or DTaP-IPV/Hib with standalone doses of HepB and Hib vaccinations administered to achieve adherence to guidelines. Researchers conducted a retrospective observations cohort study to investigate the rate of infants who receive simultaneous pentavalent and standalone vaccines, as well as the deviation in days when these vaccines were not administered concurrently.

The cohort comprised infants who were: born between July 1, 2010 and June 30, 2016, were continuously enrolled in the same insurance plan catalogued in the United States MarketScan claims and encounters database, and who had received > 3 doses of a pentavalent vaccine. Of note, as HepB vaccinations at birth were not logged in the database, researchers assumed this dose was administered, thus making the first claim for HepB a reference to the second vaccine in the series, and so forth for the second claim.

A total of 175,574 infants received DTaP-IPV/Hib, of whom 94.8% had claims that indicated completion of the HepB series. Of note, 60.7% of these infants received the second dose of HepB concurrently with the first dose of DTaP-IPV/Hib, and 45.1% received the third dose of HepB with the third dose of DTaP-IPV/Hib. Results showed that roughly half of the infants receive this last dose of HepB after the last dose of DTaP-IPV/Hib.

Conversely, of the 97,206 infants who received DTaP-HepB-IPV, 89.9% had claims that demonstrated completion of the recommended Hib vaccine series, and 91%-98% of these doses were administered concurrently with DTaP-HepB-IPV.

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Researchers concluded that variability in the timing of HepB vaccine doses may be addressed via administration of the new DTaP-IPV-Hib-HepB vaccine, thus ensuring more infants have been administered the complete series of recommended vaccinations.

Reference

Alemayehu B, Wolfson LJ, Chen Y, et al. Timing of standalone vaccine administration in infants receiving DTaP-based combination vaccines. Presented at: IDWeek 2019; October-2-6, 2019; Washington, DC. Abstract 2698.