Consumer medicine information

Hiberix

Haemophilus B conjugate vaccine

BRAND INFORMATION

Brand name

Hiberix

Active ingredient

Haemophilus B conjugate vaccine

Schedule

S4

 

Consumer medicine information (CMI) leaflet

Please read this leaflet carefully before you start using Hiberix.

What is in this leaflet?

This leaflet answers some of the common questions about HIBERIX vaccine. It does not contain all the available information. It does not take the place of talking to your doctor, nurse or pharmacist.

All medicines and vaccines have risks and benefits. Your doctor has weighed the possible risks of your child having HIBERIX against the expected benefits.

If you have any concerns about your child receiving HIBERIX talk to your doctor, nurse or pharmacist.

Keep this leaflet with this vaccine. You may need to read it again.

What is HIBERIX used for?

HIBERIX is a non-infectious vaccine used to prevent Haemophilus influenzae type b (Hib) infection in children aged 2 months to 5 years. The vaccine works by causing the body to produce its own protection (antibodies) against the disease.

Haemophilus influenzae type b is a bacteria that can cause serious life-threatening illness. Hib infection most frequently causes brain inflammation (swelling), which is generally seen in infants under 18 months of age. The death rate is 5-10% of infants in this age group. In 15-30% of surviving infants there will be some type of serious complication such as: mental retardation, cerebral palsy, deafness, epilepsy or partial blindness. Hib infection also causes inflammation of the throat, which is mostly seen in children over 18 months of age. It occasionally causes death by suffocation. Less commonly, the bacteria can also infect the blood, heart, lungs, bones, joints, and tissues of the eyes and mouth.

Vaccination is the best way to protect against Hib infection. HIBERIX vaccine is not infectious, and cannot give your child Hib infection. The vaccine will not protect against diseases caused by other types of bacteria or organisms.

Before vaccination

HIBERIX SHOULD NOT BE GIVEN IF:

  • your child has had an allergic reaction to HIBERIX, or any ingredient contained in this vaccine. The ingredients are listed at the end of this leaflet. Signs of an allergic reaction may include itchy skin rash, shortness of breath and swelling of the face or tongue.
  • If your child had HIBERIX before and became unwell, tell your doctor or nurse before the vaccine is given.
  • your child has had an allergic reaction to any other Haemophilus influenzae type b vaccine. (ie. HibTITER and PedvaxHIB)
  • your child has a severe infection with a high temperature. A minor infection such as a cold should not be a problem, but talk to your doctor or nurse about this before vaccination
  • the expiry date printed on the pack has passed
  • the packaging is torn or shows signs of tampering.

If you are not sure whether your child should have HIBERIX, talk to your doctor or nurse. Do not give this vaccine to anyone else; your doctor has prescribed it specifically for your child.

BEFORE HIBERIX IS GIVEN TELL YOUR DOCTOR OR NURSE IF:

  • your child has any medical conditions, such as an immune deficiency condition or a bleeding problem. HIBERIX may need to be given differently in children with bleeding problems.
  • your child has allergies to any other medicines or substances, such as dyes, foods or preservatives.
  • your child has received another vaccine, or is having any prescription or OTC (over-the-counter) medicines. In particular, mention if your child is being given medicines which suppress the immune system, such as high-dose steroids or cyclosporin.

Some vaccines may be affected by other vaccines or medicines. Your doctor, nurse or pharmacist will be able to tell you what to do if HIBERIX is to be given with another vaccine or medicine.

Fainting can occur following, or even before, any needle injection, therefore tell the doctor or nurse if you or your child fainted with a previous injection.

How HIBERIX is given

The doctor or nurse will give HIBERIX as an injection. If you have any concerns about how this vaccine is to be given, talk to your doctor or pharmacist.

HOW MUCH IS GIVEN

The dose of HIBERIX is 0.5mL.

HOW IS IT GIVEN

HIBERIX will be injected into the upper leg muscle in infants under 12 months of age. In children over 12 months of age the injection will be given in the upper arm muscle. For some children with bleeding problems, the dose may need to be given under the skin (subcutaneously).

The vaccine should never be given intravenously (into a vein).

HOW OFTEN IS IT GIVEN

HIBERIX is generally given as a total of three doses over 6 months. Each dose is given on a separate visit. The first dose will be given when the child is 2 months of age. The remaining two doses will be given at 4 months, and 6 months of age.

  • First dose: 2 months of age
  • Second dose: 4 months of age
  • Third dose: 6 months of age.

It is important to return at the recommended times for follow up doses.

To ensure long term protection a booster dose is generally given in the second year of life.

IF A DOSE IS MISSED

If your child misses a scheduled dose, talk to your doctor or nurse and arrange another visit as soon as possible.

While you are taking HIBERIX

THINGS YOU MUST DO:

Keep your child’s follow up visits with the doctor, nurse or clinic. It is important the 2 follow-up doses of HIBERIX are given at the correct times. This will ensure the best effect of the vaccine in protecting your child against Hib infection.

What are the side effects?

Tell your doctor or nurse as soon as possible if your child does not feel or look well during or after having had a dose of HIBERIX.

HIBERIX helps protect most children from Hib infection, but it may have unwanted side effects in a few children. All medicines and vaccines can have side effects. Sometimes they are serious; most of the time they are not. Some side effects may need medical treatment.

Ask your doctor, nurse or pharmacist to answer any questions you may have.

Like other vaccines, most unwanted effects with HIBERIX are mild and usually clear up within a few days.

MILD EFFECTS

Tell your doctor if your child has any of the following that are troublesome or ongoing:

  • pain, redness or swelling around the injection site
  • restlessness, unusual crying, sleeplessness or tiredness
  • loss of appetite, vomiting or diarrhoea
  • fever, cough, runny nose or symptoms of a cold
  • irritability
  • skin rash or bruising.
  • if your child has breathing difficulties, please contact your doctor. This may be more common in the first three days following vaccination if your child is born prematurely (before or at 28 weeks of pregnancy).

Other events that have been reported with HIBERIX include:

  • fainting due to injection
  • feeling sleepy
  • temporarily stopping breathing
  • hives, rash
  • large swelling of the injected limb
  • hard lump at the injection site

MORE SERIOUS EFFECTS

As with all vaccines given by injection there is a very small risk of serious allergic reaction. Contact your doctor immediately or take your child to the casualty department of your nearest hospital if any of the following happens:

  • fits (including fits due to fever)
  • swelling of limbs, face, eyes, inside of nose, mouth or throat
  • shortness of breath, breathing or swallowing difficulties
  • hives, itching (especially of the hands or feet), reddening of skin (especially around the ears) or severe skin reactions
  • unusual tiredness or weakness that is sudden and severe
  • Collapse (sudden onset of muscled floppiness), periods of unconsciousness or lack of awareness, and paleness or bluish skin discolouration
  • Allergy to HIBERIX is rare. Any such severe reactions will usually occur within the first few hours of vaccination.

Other side effects not listed above, can also occur during or soon after a dose of HIBERIX.

Check with your doctor if your child has any other effects.

Do not be alarmed by this list of possible side effects. Your child may not experience any of them.

How do I store HIBERIX?

HIBERIX is usually stored at the doctor’s clinic or surgery, or at the pharmacy. But if you need to store HIBERIX always:

  • Keep HIBERIX in the refrigerator stored between 2°C and 8°C. DO NOT FREEZE.
  • Keep the vaccine out of the reach of children.
  • Keep HIBERIX in the original pack until it is time for it to be given.

Ask your pharmacist what to do with any left over HIBERIX that has expired or has not been used.

Product description

WHAT IT LOOKS LIKE

HIBERIX comes as a white powder in a glass vial, with a sterile saline diluent presented in a prefilled syringe.

INGREDIENTS:

The active ingredient of HIBERIX is a non-infectious extract from Haemophilus influenzae type b bacteria bound to tetanus toxoid. Each 0.5 mL dose contains:

  • 10 mcg of Haemophilus influenzae type b polysaccharide conjugated to approximately 25 mcg tetanus toxoid as a carrier protein.

The inactive ingredients in the vaccine are: lactose, sodium chloride (salt), and water.

The manufacture of this product includes exposure to bovine derived materials. No evidence exists that any case of vCJD (considered to be the human form of bovine spongiform encephalopathy) has resulted from the administration of any vaccine product.

HIBERIX is supplied in Australia by:

GlaxoSmithKline Australia Pty Ltd
Level 4, 436 Johnston Street,
Abbotsford, Victoria, 3067

Where to go for further information

HIBERIX is only available if prescribed by a doctor.

This leaflet was prepared on 28 April 2016

The information provided applies only to: HIBERIX®.

HIBERIX is a registered trade mark of the GSK group of companies.

HIBERIX comes as single or 10 dose packs containing:
a white powder in a glass vial and the diluent in a prefilled syringe (AUST R 60881).

Version 5.0

© 2016 GSK group of companies. All rights reserved.

Published by MIMS August 2017

BRAND INFORMATION

Brand name

Hiberix

Active ingredient

Haemophilus B conjugate vaccine

Schedule

S4

 

1 Name of Medicine

Haemophilus influenzae type b (Hib) vaccine.

2 Qualitative and Quantitative Composition

After reconstitution, 1 dose (0.5 mL) contains:
Haemophilus influenzae type b polysaccharide 10 microgram;
conjugated to tetanus toxoid as carrier protein approximately 25 microgram.
Hiberix is a non-infectious vaccine containing purified polyribosyl-ribitol-phosphate capsular polysaccharide (PRP) of Haemophilus influenzae type b covalently bound to tetanus toxoid.
Hiberix is supplied as a white lyophilised powder for reconstitution with a diluent (sterile 0.9% saline solution). The diluent is supplied as a clear and colourless liquid.
The manufacture of this product includes exposure to bovine derived materials. No evidence exists that any case of vCJD (considered to be the human form of bovine spongiform encephalopathy) has resulted from the administration of any vaccine product.

List of excipients with known effect.

For the full list of excipients, see Section 6.1 List of Excipients.

3 Pharmaceutical Form

Powder and diluent for solution for injection.
Hiberix is presented as a white lyophilised powder in a glass vial. The sterile 0.9% saline diluent is clear and colourless and presented in a pre-filled syringe.

4 Clinical Particulars

4.1 Therapeutic Indications

Hiberix is indicated for active immunisation against Haemophilus influenzae type b infection in children aged from 2 months to 5 years.

4.2 Dose and Method of Administration

Hiberix is supplied as a white lyophilised powder for reconstitution with sterile 0.9% saline diluent. Hiberix is prepared as detailed below (see Section 4.2 Dose and Method of Administration, Directions for reconstitution).
The recommended dose is 0.5 mL.
Hiberix vaccine must be administered by intramuscular injection. In infants and children under 12 months of age it is preferable to inject the vaccine in the anterolateral thigh because of the small size of their deltoid muscle. In children over 12 months of age the injection can alternatively be given in the deltoid region. The vaccine should be administered subcutaneously in patients with thrombocytopenia or bleeding tendencies, e.g. haemophiliacs (see Section 4.4 Special Warnings and Precautions for Use).
Hiberix must not be given intravenously.
The recommended primary vaccination courses consists of three doses at 2, 4 and 6 months of age. To ensure long-term protection, a booster dose is recommended in the second year of life. As vaccination schemes vary from country to country, the schedule for each country may be used in accordance with the different national recommendations. Refer to the Australian Immunisation Handbook for further guidance.

Directions for reconstitution.

The diluent and reconstituted vaccine should be inspected visually for any foreign particulate matter and/or variation of appearance prior to reconstitution or administration. If either is observed, do not use the diluent or the reconstituted vaccine.

Instructions for reconstitution of the vaccine with the diluent presented in pre-filled syringe.

Hiberix must be reconstituted by adding the entire contents of the pre-filled syringe of diluent to the vial containing the powder.
To attach a needle to the syringe, carefully read the instructions given (see Figures 1 and 2). However, the syringe provided with Hiberix might be slightly different than the syringe illustrated.
Always hold the syringe by the barrel, not by the syringe plunger or the Luer Lock Adaptor (LLA), and maintain the needle in the axis of the syringe (see Figure 2). Failure to do this may cause the LLA to become distorted and leak.
During assembly of the syringe, if the LLA comes off, a new vaccine dose (new syringe and vial) should be used.
1. Unscrew the syringe cap by twisting it anticlockwise (as illustrated in Figure 1).
2. Attach the needle to the syringe by gently connecting the needle hub into the LLA and rotate a quarter turn clockwise until you feel it lock (as illustrated in Figure 2).
3. Remove the needle protector, which may be stiff.
4. Add the diluent to the powder. The mixture should be well shaken until the powder is completely dissolved in the diluent.
The reconstituted vaccine is a clear to opalescent and colourless solution.
After reconstitution, the vaccine should be used promptly or kept in a refrigerator. If it is not used within 24 hours, it should be discarded because of the risk of contamination.
5. Withdraw the entire contents of the vial.
6. A new needle should be used to administer the vaccine. Unscrew the needle from the syringe and attach an injection needle by repeating step 2.
Inject the entire contents of the syringe.
Any unused product or waste material should be disposed of in accordance with local requirements.

4.3 Contraindications

Hiberix should not be administered to subjects with known hypersensitivity to any component of the vaccine, or to subjects having shown signs of hypersensitivity after previous administration of Hib vaccines.
As for any vaccine, Hiberix should not be administered to subjects suffering from acute severe febrile illness. However, the presence of minor infection does not contraindicate vaccination.

4.4 Special Warnings and Precautions for Use

Hiberix should under no circumstances be administered intravenously.
It is good clinical practice that any vaccination be preceded by a review of medical history (especially with regard to previous vaccinations and possible adverse events) and a clinical examination.
As with all injectable vaccines, appropriate medical treatment and supervision should always be readily available in case of anaphylactic reactions following the administration of the vaccine.
Native populations (native Alaskans, native American Indians) with a high incidence of Haemophilus influenzae type b disease have shown a reduced antibody response to conjugated Haemophilus influenzae type b vaccines. The immunogenicity of Hiberix has not been studied in the Australian aboriginal population and the possibility of a lower antibody response than that seen in clinical studies should be borne in mind.
Human Immunodeficiency Virus (HIV) infection is not a contraindication to vaccination. However an adequate antibody response may not be obtained in patients with an immunodeficiency disorder or in patients receiving immunosuppressive therapy (see Section 4.5 Interactions with Other Medicines and Other Forms of Interactions).
Hiberix should be administered subcutaneously in patients with thrombocytopenia or bleeding disorders (e.g. haemophiliacs) since bleeding after intramuscular injection may occur in these patients (see Section 4.2 Dose and Method of Administration).
Urinary excretion of the capsular polysaccharide antigen has been reported following Hib vaccination. Therefore antigen detection within 1-2 weeks of vaccination may not be of diagnostic value in suspected Hib disease.
An immune response to the tetanus toxoid component may occur following Hiberix vaccination, however this does not substitute for routine tetanus vaccination.
Hiberix will not protect against diseases caused by other types of Haemophilus influenzae, or meningitis caused by other organisms.
The potential risk of apnoea and the need for respiratory monitoring for 48 to 72 hours should be considered when administering the primary immunisation series to very premature infants (born ≤ 28 weeks of gestation) and particularly for those with a previous history of respiratory immaturity. As the benefit of vaccination is high in this group of infants, vaccination should not be withheld or delayed.
Syncope (fainting) can occur following, or even before, any vaccination as a psychogenic response to the needle injection. It is important that procedures are in place to avoid injury from faints.

Use in the elderly.

No data available.

Paediatric use.

See Section 4.4 Special Warnings and Precautions for Use.

Effects on laboratory tests.

No data available.

4.5 Interactions with Other Medicines and Other Forms of Interactions

Hiberix may be administered either simultaneously, or at any time before or after different live or inactivated vaccines. However, different injectable vaccines administered concurrently should always be given in separate sites using separate syringes.
Clinical trials have shown concomitant administration of Hiberix and the diphtheria-tetanus-pertussis (acellular or whole-cell) combination vaccines does not affect the immunogenicity of either vaccine, provided the vaccines are given at separate sites and not mixed prior to administration.
As with other vaccines, it may be expected patients receiving immunosuppressive therapy (e.g. high-dose steroids or cyclosporin) or patients with an immunodeficiency may not achieve an adequate immune response (see Section 4.4 Special Warnings and Precautions for Use).
Hiberix must not be mixed with other vaccines in the same syringe.

4.6 Fertility, Pregnancy and Lactation

Effects on fertility.

No data available.
(Category B2)
The effect of Hiberix on foetal development is unknown. Therefore, vaccination of pregnant women cannot be recommended.
The effect of Hiberix in lactation has not been assessed, as the vaccine is not intended for adult use.

4.7 Effects on Ability to Drive and Use Machines

The effects of this medicine on a person's ability to drive and use machines were not assessed as part of its registration.

4.8 Adverse Effects (Undesirable Effects)

Clinical trial data.

In the initial controlled clinical trials for registration, signs and symptoms were actively monitored for the first 4-8 days following Hiberix vaccination and recorded on diary cards. The vaccine was generally well tolerated and most local adverse events were considered to be mild and transient. The incidence of local adverse events did not increase with subsequent vaccine doses. As Hiberix has been co-administered with either a diphtheria-tetanus-acellular pertussis vaccine or a diphtheria-tetanus-whole cell pertussis vaccine, systemic adverse events cannot be specifically attributed to either vaccine. Most systemic events were mild and resolved spontaneously.
Data are also available from two large studies, Hib-097 and DTPa-HPV-IPV-011, in which children were vaccinated with Hiberix.
The following frequencies were based on the analysis of the initial clinical studies as well as studies Hib-097 and DTPa-HPV-IPV-011.
Events are listed within body systems and categorised by frequency according to the following definitions.
Very common: ≥ 1/10; common: ≥ 1/100 to < 1/10; uncommon: ≥ 1/1000 to < 1/100; rare: ≥ 1/10,000 to < 1/1000; very rare: < 1/10,000.

Local reactions.

Very common: redness (> 2.0 cm); pain, swelling (> 2.0 cm).

Body as a whole.

Very common: fever. Common: viral infection. Uncommon: asthenia, fatigue, injury. Rare: allergic reactions including anaphylactoid reactions.

Dermatological.

Common: rash erythematous, injection site reaction. Uncommon: sweating increased, purpura.

Gastrointestinal.

Very common: loss of appetite, vomiting, diarrhoea. Common: gastroenteritis. Uncommon: abdominal pain.

Musculoskeletal.

Uncommon: spastic paralysis.

Nervous system.

Very common: irritability, restlessness, unusual crying; somnolence. Common: nervousness. Uncommon: insomnia, emotional lability. Rare: convulsions (including febrile convulsions).

Respiratory.

Common: rhinitis, coughing, respiratory disorder, upper respiratory tract infection, bronchitis.

Special senses.

Common: conjunctivitis, otitis media.
No serious adverse event was considered by investigators to be related to Hiberix alone. In two serious adverse events considered related or possibly related to vaccination, Hiberix was administered simultaneously with an acellular DTP vaccine.

Post-marketing data.

Immune system disorders.

Very rare: allergic reactions (including anaphylactic and anaphylactoid reactions), angioedema.

Nervous system disorders.

Very rare: hypotonic-hyporesponsive episode, convulsion (with or without fever), syncope or vasovagal responses to injection, somnolence.

Respiratory, thoracic and mediastinal disorders.

Very rare: apnoea [see Section 4.4 Special Warnings and Precautions for Use, Paediatric use for apnoea in very premature infants (≤ 28 weeks of gestation)].

Skin and subcutaneous tissue disorders.

Very rare: urticaria, rash.

General disorders and administration site conditions.

Very rare: extensive swelling of vaccinated limb, injection site induration.

Reporting suspected adverse effects.

Reporting suspected adverse reactions after registration of the medicinal product is important. It allows continued monitoring of the benefit-risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions at www.tga.gov.au/reporting-problems.

4.9 Overdose

In general, the adverse event profile reported following overdosage was similar to that observed after administration of the recommended dose of Hiberix.
For information on the management of overdose, contact the Poisons Information Centre on 13 11 26 (Australia).

5 Pharmacological Properties

5.1 Pharmacodynamic Properties

Mechanism of action.

The protective efficacy of Hiberix has not been studied in field trials. Hiberix has however been shown to induce anti-PRP antibodies above the level known to be protective against invasive disease due to Haemophilus influenzae type b. An anti-PRP antibody titre ≥ 0.15 microgram/mL correlates with immediate protection against Hib infection and ≥ 1.0 microgram/mL correlates with long-term protection.

Clinical trials.

The immunogenicity of Hiberix has been investigated in clinical studies involving over 300 infants (over 2 months of age) using a 3 dose primary vaccination schedule. Protective anti-PRP antibody titres were demonstrated in 95-100% (≥ 0.15 microgram/mL) and 87-90% (≥ 1.0 microgram/mL) of infants one month after completion of the primary schedule.
Clinical trials have demonstrated the immunogenicity of Hiberix is unaltered by administration of different primary vaccination schedules. One month after completion of a 2, 4, 6 month or 3, 4, 5 month primary schedule, over 95% of infants in each group obtained anti-PRP titres ≥ 0.15 microgram/mL.
A boosting dose of Hiberix was given either separately (n = 19) or in combination with DTPa (n = 56) to infants aged between 15 and 18 months who had previously received primary immunisation with Hiberix and DTPa given at separate sites. One month after administration of this booster dose, an anamnestic response was observed with anti-PRP antibody titres of ≥ 0.15 microgram/mL and ≥ 1.0 microgram/mL being obtained in 100% and greater than 94% of infants respectively.

5.2 Pharmacokinetic Properties

Not relevant to vaccines.

5.3 Preclinical Safety Data

Genotoxicity.

No data available.

Carcinogenicity.

No data available.

6 Pharmaceutical Particulars

6.1 List of Excipients

The reconstituted vaccine preparation contains the excipients lactose, sodium chloride and water for injection.

6.2 Incompatibilities

See Section 4.5 Interactions with Other Medicines and Other Forms of Interactions.

6.3 Shelf Life

In Australia, information on the shelf life can be found on the public summary of the Australian Register of Therapeutic Goods (ARTG). The expiry date can be found on the packaging.

6.4 Special Precautions for Storage

Hiberix must be stored between 2°C to 8°C, and protected from light. The lyophilised Hib vaccine is not affected by freezing. The sterile 0.9% saline diluent may be stored in the refrigerator (at 2°C to 8°C) or stored at ambient temperatures, but must not be frozen.

6.5 Nature and Contents of Container

The vials and pre-filled syringes are made of neutral glass type 1.
Hiberix is presented as a singles or tens pack.
Not all pack sizes may be distributed in Australia.

6.6 Special Precautions for Disposal

In Australia, any unused medicine or waste material should be disposed of by taking to your local pharmacy.

6.7 Physicochemical Properties

Not relevant to vaccines.

7 Medicine Schedule (Poisons Standard)

Schedule 4 - Prescription Only Medicine.

Summary Table of Changes