In 1987, the HiB vaccine was introduced in the United States to reduce the approximately 20,000 cases of invasive disease (meningitis, epiglottis, bacteremia) seen annually. Since its introduction, the incidence of HiB infections has declined by 98 percent. The 600 children who had died each year from invasive HiB before the introduction of the vaccine are no longer statistics – they are now in high school and college.

Those of us who completed our residencies prior to 2000 know about invasive pneumococcal infections. Pneumococcus was the bug that killed over 6,000 children each year, and affected many more by way of deafness or seizures. When faced with a sick child, we knew to consider it, include it in our differential, and like our slightly older HiB-seasoned predecessors, to respect it. Since the pneumococcal conjugate vaccine was introduced, the incidence of invasive disease in children has declined by 75 percent


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