Introduction
The recent progress in medicine, healthcare, and pharmacology provides millions of people with an opportunity to avoid dangerous viruses, bacteria, and deaths. The prevention and control of diseases by means of well-timed immunization practices and vaccinations gain popularity in many countries. Despite the fact that until the 1980s, Haemophilus influenza type b (Hib) was defined as one of the leading causes of bacterial meningitis, pneumonia, and epiglottitis among children, first reports on this infection were introduced only at the beginning of the 1990s (Centers for Disease Control and Prevention, 2015).
Several types of vaccinations against Hib were introduced during the next decades till it became possible to immunize children from two months, as well as adults who missed this type of vaccination for any reason. This paper aims at examining the topic of Hib vaccine as prevention of epiglottitis and identifying current studies and guidelines. At this moment, Hib vaccines can prevent the development of such a life-threatening condition as epiglottitis, the danger of which lies in the possibility to provoke acute inflammation and increase the risks of airway obstruction.
Literature Review
Epiglottitis
As soon as children are born, they become exposed to a variety of bacteria and viruses. Despite their parents’, caregivers’, and healthcare practitioners’ intentions to provide them with support and protection, immunization remains one of the most effective preventing methods. Epiglottitis is a type of inflammatory disease that is characterized by some changes in the epiglottis because of the presence of cartilage in the windpipe (Chen, Natarajan, Bianchi, Aue, & Powers, 2018).
This condition is usually observed among patients who suffer from immunodeficiency, poor immune response, or neutropenia (Chen et al., 2018). According to the investigations developed by Zarei, Almehdar, and Redwan (2016), Hib epiglottitis was a frequent cause of death among children during the pre-vaccination era. However, Hib can also lead to a number of severe infections in addition to the already mentioned epiglottitis. They include sepsis, pneumonia, meningitis, and other invasive Hib diseases that occur among children who are younger than 5 years (Centers for Disease Control and Prevention, 2015). The symptoms of the presence of this infection in the body are fever, sore throat, abnormal breathing, and problematic swallowing.
Importance of Vaccination
Special attention was paid to the situations when deaths from an infection became a burden. Globally, more than 1.5 million children died from diseases that could be easily prevented by a vaccine (Zarei et al., 2016). In 2000, more than 8 million illnesses were based on Hib, with more than 300 deaths in children younger than 5 years (Le, Nghiem, & Swint, 2016). The decision to elaborate a solution to this problem was made. Two tests for serotyping H. influenza isolates were developed and proved that the spread of this infection could be prevented (Centers for Disease Control and Prevention, 2015).
Slide agglutination was offered to detect the bacterium’s antigen in cerebrospinal fluid; as no positive results were achieved, serotype-specific real-time polymerase chain reaction helped to identify the gene in the blood (Centers for Disease Control and Prevention, 2015). Hib could affect both children with no properly established immune system and adults who had certain medical conditions (Bright Pediatrics, 2018). Therefore, the period of vaccination could be changed in regard to patients’ needs and conditions.
Hib Vaccine Use
There are many specific guidelines developed by the Centers for Disease Control and Prevention, Bright Futures, and the American Academy of Pediatrics on how to promote immunization against Hib-related diseases, including epiglottitis. Vaccination usually begins at the age of 2 months and can be offered to adult patients, depending on their health needs, specific conditions, and living areas. The recent investigation by the American Academy of Pediatrics shows that a purple bar was added to Hib vaccine in order to underline the importance of immunization for high-risk children who belong to the 5-18-year-old group (Meisser, 2016).
In addition, the same recommendation was given to the group of children under 9 years who have a sexual abuse history (Meisser, 2016). Parents are provided with a list of recommendations about the need for vaccination and prediction of Hib diseases. Epiglottitis, in particular, may contribute to a number of complications that are based on respiratory failure and the inability to breathe independently with time, and the possibility to spread new infections in the body and challenge the bloodstream.
Despite a number of positive effects of Hib vaccine, patients should also remember its side effects and be aware of the steps to be taken to protect their health and avoid serious complications. For example, allergic reactions to some of the vaccine’s compounds can be observed (Centers for Disease Control and Prevention, 2015). The main signs of an allergy are breathing changes, weakness, and hives. Sometimes, children may experience dizziness shortly after the vaccine is taken but fail to tell about it because of a young age.
Therefore, parents have to observe their kids thoroughly and report on any mood, behavioral, or emotional change. Fever and pain are the effects that are rarely observed; still, they cannot be neglected, and parents must be prepared to relieve their kids’ pain by Ibuprofen or another appropriate medication. Finally, if children are diagnosed with other acute diseases, Hib vaccination to prevent epiglottitis has to be postponed until their full recovery.
Economic Outcomes
Although Hib vaccine was introduced at the end of the 1990s, it was unavailable to many people from low-income countries. As a result, access to this preventable method turned out to be a serious economic challenge. Only 8% of the population in poor countries received Hib vaccine by 2003 (Le et al., 2016). Healthcare needs to be intertwined with the current economic conditions, and nations had to develop new approaches on how to get access to the required vaccine.
The establishment of the Global Alliance for Vaccines and Immunizations, also known as GAVI, was the first solution to change the current situation. This organization works together with the WHO, the World Bank, and many pharmaceutical companies to contribute to the production of more Hib vaccines to prevent epiglottitis and other associated diseases.
GAVI was the first organization that participated in the promotion of Hib vaccination for the population. Regarding the current research evidence, these steps resulted in the possibility to save about six million lives during the last five years (Le et al., 2016). During the last 15 years, more than 200 million children received Hib vaccine, with 57% of them being from low-income countries (Le et al., 2016). Health equity was considerably improved due to the activities of GAVI and the participation of the government in Hib immunization.
Vaccination Guidelines
As soon as the necessity to use Hib vaccine to prevent epiglottitis and other bacteria-related diseases was approved, many organizations focus their activities on the development of appropriate guidelines. According to the Centers for Disease Control and Prevention (2015), Hib vaccination is not recommended to patients who are older than 59 months because the majority of children are able to support the immune system and respond to Hib properly.
Still, there is also a group of patients who are at considerable risk for Hib diseases. These people usually have problems with spleen functions, decreased immunity, HIV infection, and some other diseases that include the necessity to take chemotherapy or radiation therapy (Centers for Disease Control and Prevention, 2015). However, each patient has to consult a physician or another healthcare professional before making a final decision and use immunization as a step to prevent epiglottitis.
Immunization schedules are usually approved by several organizations, including the American Academy of Pediatrics. In collaboration with the Advisory Committee on Immunization Practices, the Academy develops schedules for children from birth to 18 years of age (Meisser, 2016). There are also special hints for parents that can be found at local hospitals, clinical centers, and online. For example, Bright Pediatrics PC (2018) states that Hib immunization should occur at the age of 2 months (first dose), 4 months, 6 months, and 15 months (booster dose).
It is possible to give this vaccine along with other vaccines. Epiglottitis is a medical emergency that is hard to predict, and vaccination is an effective means to try to prevent its development and associated complications (Chen et al., 2018). The recognition of this condition is possible: patients may experience voice changes or suffer from sepsis outcomes. Laryngoscopy and radiology may be recommended to examine an inflamed area and make a final diagnosis (Chen et al., 2018). It is necessary to admit that the introduction of Hib vaccine has already significantly decreased the number of epiglottitis and other invasive diseases.
Worth of Findings
The process of search for evidence about the effects of Hib vaccination on the prevention of epiglottitis aims at using credible and reliable sources. On the one hand, there are not many studies where the direct effects of Hib vaccine are discussed in regards to the prevention of epiglottitis. These literature gaps can motivate potential researchers to investigate this area and make their own contributions. On the other hand, epiglottitis is a disease that belongs to a group of invasive infectious diseases like meningitis, pneumonia, sepsis, and osteomyelitis (Le et al., 2016).
These diseases have been thoroughly investigated by a number of researchers in their studies about the worth of Hib vaccine programs (Le et al., 2016), the peculiarities of the immunocompromised host (Chen et al., 2018), and the perspectives of Hib vaccines (Zarei et al., 2016). The credibility of these studies can be proved by the fact that all of them are peer-reviewed articles published within the last five years.
Using “Google Scholar” as the main search engine, it is possible to find out more than 400 studies on a similar topic on the basis of such key terms as “Haemophilus influenza type b” and “epiglottitis.” If “vaccination” is added to the list of search words, the number of studies can be decreased up to about 300 sources. These studies are characterized by rather small samples because the authors find it necessary to discuss particular cases to investigate the worth of Hib vaccination in pediatric patients. In some articles, samples can include between 30 and 50 participants. However, the review of the literature provides a possibility to include more sources and use the results that have already been obtained.
As a Pediatric Nurse Practitioner, I find these findings and explanations rather helpful for my future career and the role that I have to perform. These sources contain credible statistical data and guidelines on how Hib vaccination should occur, what patients are at high risk of having adverse reactions to vaccination and exposed to epiglottitis or other invasive infections. In addition, I can learn about the history of the chosen vaccine’s development and urgency. The pre-vaccine era was characterized by increased cases of meningitis and epiglottitis and death of children at an early age regardless of the fact that this infection was preventable (Centers for Disease Control and Prevention, 2015).
Such facts and the role of GAVI in the introduction of vaccines make me believe in the role of a human factor in disease control and prevention. Some people may not allow themselves to pay for immunization, and the government continues taking steps to solve this problem and provide people with new options. Any nurse practitioner has to learn how to cooperate, support, and make decisions, and all these findings contribute to developing the necessary skills.
To continue learning immunization processes and the threat of epiglottitis and similar diseases, it is recommended to use the offered sources and consult official websites of such organizations like the Centers for Disease Control and Prevention, Bright Futures, and the American Academy of Pediatrics. Education on when to vaccinate children and what side effects may be observed plays an important role for both patients and healthcare/medical workers (Bright Pediatrics PC, 2018; Meisser, 2016).
After being born, children are in need of additional support and health care, and the vaccine is one of the methods to achieve child well-being at a reasonable price. Knowledge about vaccination and infectious diseases has to be regularly improved because of new achievements and discoveries. The existence of the pre-vaccine era and the losses and challenges that people experienced make modern families and doctors understand the need for progress and the worth of immunization (Centers for Disease Control and Prevention, 2015). If there is a chance to avoid a disease or, at least, try to predict it, it has to be used.
Conclusion
In general, Hib vaccine that is used to prevent epiglottitis cannot be neglected by modern families and healthcare providers. It is not enough to know about the existence of this method, but it is necessary to take certain steps and get benefits from the offered options. The nursing practice may be considerably improved when people start reading guidelines offered by such professional organizations as the Centers for Disease Control and Prevention.
Research studies are created for people to enlarge their understanding of a topic and get prepared for different activities and collaborations. Today, statistical data about epiglottitis and Hib vaccine, real-life examples, and tests are available to patients. Although pediatric patients can hardly read this material, their parents may receive the necessary information and made important decisions to promote health and avoid serious complications.
References
Bright Pediatrics PC. (2018). Immunizations. Web.
Centers for Disease Control and Prevention. (2015). Haemophilus influenza type b.
Chen, C., Natarajan, M., Bianchi, D., Aue, G., & Powers, J. H. (2018). Acute epiglottitis in the immunocompromised host: Case report and review of the literature. Open Forum Infectious Diseases, 5(3), 1-5. Web.
Le, P., Nghiem, V. T., & Swint, J. M. (2016). Post-GAVI sustainability of the haemophilus influenzaetype b vaccine program: The potential role of economic evaluation. Human Vaccines & Immunotherapeutics, 12(9), 2403–2405. Web.
Meisser, H. C. (2016). 2016 immunization schedules include several updates. AAP News.
Zarei, A. E., Almehdar, H. A., & Redwan, E. M. (2016). Hib vaccines: Past, present, and future perspectives. Journal of Immunology Research, 2016, 1–18. Web.