HiB Vaccine and Serotype Replacement

Hib vaccine has undoubtedly caused a vast decrease in the incidence of type b Haemophilus Influenza. However, this decrease in type B has been offset by a significant increase in non type b forms of Haemophilus Influenza. Recommending patients to take the risk of neurological disorders, encephalopathy, permanent brain damage and anaphylaxis (plus an increased risk of HiB for one week post vaccination), all of which are conceeded as causal serious adverse reactions on the product insert(http://www.novaccine.com/pdffiles/Act_HIB_package_insert.pdf).... for the sake of their child probably just ending up with another serotype of the same form of meningitis, is logically unstable and ethically questionable.

References of Serotype Replacement Documentation:

"In addition to the proportional increasei n cases of non type b Haemophilus influenzae disease in the post H influenzae type b vaccine era, the incident of invasive H influenzae disease was found to be approaching the rates of H Influenzae type b disease that were documented in the pre vaccine period."
Tsang RS; "Characterization of invasive Haemophilus influenza disease in Manitoba Canada, 2000-2006: invasive disease due to non type b strains." Clin Infect Dis. 2007 June 15;44(12):1611-4
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"Non-capsulate H influenzae isolates have shown an increase in annual attack rate (for all ages) from 0.25 cases per 100000 population in 1990-1 (45 cases recorded) to 0.37 in 1993-4 (67 cases). The total number of recorded cases of non-type b infections (non-capsulate and other serotypes: 75 cases) exceeded the number of cases of H influenzae type b (50 cases) in 1993-4. These increases demonstrate a sustained trend, approaching significance for non-capsulate infections during 1993-4 (P=0.066)."

Ruth M Hargreaves, Mary P E Slack,"Changing patterns of invasive Haemophilus influenzae disease in England and Wales after introduction of the Hib vaccination programme"; BMJ 1996;312:160-161 (20 January)

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Waggoner-Fountain LA; "The emergence of Haemophilus influenzae types e and f as significant pathogens."; Clin Infect Dis 1995 Nov;21(5):1322-4

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Korgenski EK, "Invasive serotype a Haeomophilus influnzae infections with a virulence genotype resembing Haemophilus influenzae type b: emerging pathogen in the vaccine era?"; 1: Pediatrics. 2001 Jul;108(1): E18
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Ribeiro GS, "Prevention of Haemophilus influenz type b (Hib) meningitis and emergence of serotype replacement with type a strains after introduction of the HiB imunization in Brazil." J Infect Dis. 2003 Jan 1;187(1):109-16

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Heath PT, "Non type b Haemophilus influenzae disease: clinical and epidemiologic characteristics in the Haemophilus influenzae type b vaccine era." Pediatr Infect Dis J. 2001 Mar;20(3):300-5

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Mulhelmann K, "Molecular characteristics of Haemophilus influenzae causing invasive disease during the period of vaccination in Switzerland: analysis of isolated strains between 1986 and 1993." J Clin Microbiol. 1996 Mar;34(3)560-3

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Campos J; "Analysis of invasive Haemophilus influenzae infections after extensive vaccination against H. influenzae type b". J Clin Microbiol. 2004 Feb;42(2):524-9