Invasive Haemophilus influenzae Disease in Alaskan Residents Aged 10 Years and Older Before and After Infant Vaccination Programs

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Abstract
Since 1980 the Centers for Disease Control and Prevention's (CDC's) Arctic Investigation Program (AIP) in Anchorage, Alaska, has conducted active surveillance for invasive Haemophilus influenzae throughout Alaska. Early studies revealed that Alaska Native children experienced a rate of invasive H influenzae disease 6 to 10 times that of their nonnative counterparts.1 Statewide H influenzae type b (Hib) vaccination programs, begun in 1991, have led to a decline in the annual incidence of Hib disease in Alaska Natives from 25 to 40 cases to 1 to 3 cases in children younger than 5 years.2 Of children born in Alaska between 1993 and 1995, 84% received 3 or more doses of Hib conjugate vaccine.3 Immunization rates among Alaska Native children are higher. Between 1994 and 1998, an average of 90% to 95% of urban and 88% to 91% of rural Alaska Native children aged 2 years had received at least 3 doses of Hib conjugate vaccine.4 The impact of Hib vaccine programs on the incidence of H influenzae disease in older Alaskan children and adults has not been evaluated.

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