Risk of omitting Hib when administering Infanrix-IPB+Hib

This Rapid Response Report alerts primary care organisations to the need to administer the Haemophilus influenzae type b (Hib) component of Infanrix-IPV+Hib, a combined pre-school booster vaccine. This is part of the Hib Catch-up campaign, which applies to children born between March 2003 and September 2005.

The NPSA is aware of 80 reported incidents (some involving multiple patients) of children not receiving the Hib component up to mid-October 2008 across England and Wales.

The manufacturer also received 68 calls about the problem in September 2008 and a further 19 in early October 2008. Anecdotal information suggests further incidents which have not been reported.

Each practice or vaccination clinic should be able to demonstrate that:

• All staff who prepare and administer childhood vaccines are aware of correct methods of preparation for all vaccines, including Infanrix-IPV+Hib.
• They have checked that patient information leaflets and instructions for use in English are available with each dose at the time it is given.
• They have procedures in place to review practice for administering Infanrix-IPV+Hib and for identifying all children in the current Hib Catch-up campaign at risk of not receiving the Hib component. 
• Local procedures and policies have been reviewed to incorporate the above and this is reflected in Patient Group Directions (or equivalent in Wales), where applicable.
• Problems such as these are reported via local incident reporting systems.