The AlaskaHaemophilus influenzaeType b Experience: Lessons in Controlling a Vaccine-Preventable Disease

OBJECTIVE. Before 1991, Alaska Native children experienced one of the highest rates of invasive Haemophilus influenzae type b disease. H influenzae type b vaccine has led to a near-elimination of invasive H influenzae type b disease in the United States. We describe challenges encountered in controlling H influenzae type b disease in Alaska and update the current status of H influenzae disease and carriage in Alaska as lessons to other populations.PATIENTS AND METHODS. We reviewed data from statewide H influenzae disease surveillance conducted during 1980–2004. Vaccine coverage data were based on audits from tribal facilities and the National Immunization Survey. H influenzae type b colonization data were based on 6 carriage studies.RESULTS. After universal infant vaccination in 1991, H influenzae type b disease among Alaska Native and non-Native children CONCLUSIONS. H influenzae type b vaccination has resulted in a dramatic decrease in invasive H influenzae type b disease in Alaska; however, despite high rates of H influenzae type b vaccine coverage, H influenzae type b disease rates among rural Alaska Native children