A potentially deadly bacterial disease, Haemophilus influenzae type b (Hib), is making a concerning return, according to doctors. This resurgence is linked to falling vaccination rates, raising fears of a preventable public health crisis.

A Personal Reminder of Hib's Severity

Dr. Lara Johnson, chief medical officer at Covenant Children’s Hospital in Lubbock, Texas, carries a visible reminder of Hib’s impact – a scar from an emergency tracheostomy performed when she was four years old. In 1980, she contracted Hib, which attacked her epiglottis, obstructing her airway.

“I had a fever and felt like I was choking,” recalls Dr. Johnson. “I thought I needed to throw up.” She underwent a tracheostomy to breathe and was treated with antibiotics, eventually recovering. Prior to the Hib vaccine, approximately 20,000 children in the U.S. developed severe Hib infections annually, leading to around 1,000 deaths, according to the Centers for Disease Control and Prevention (CDC).

Dramatic Decline After Vaccine Introduction

The introduction of the Hib vaccine in 1987 dramatically changed the landscape. Infections plummeted to fewer than 50 cases per year. Many doctors practicing today have never encountered a case of Hib.

Rising Concerns Over Declining Vaccination Rates

However, vaccination rates are now slipping. The CDC recently reported a slight decrease in the percentage of babies receiving the complete Hib vaccine series, falling from 78.8% in 2019 to 77.6% in 2021. This trend is alarming doctors like Dr. Johnson, who recently treated children hospitalized with measles during a West Texas outbreak.

“Measles is the beginning,” stated Dr. Leisha Nolen, Utah’s state epidemiologist, referencing the ongoing measles outbreak with 559 cases as of Tuesday. She fears Hib could be the next vaccine-preventable disease to experience a comeback. “It’s really tragic to think we’re going to have to go back to having emergency rooms filled with little babies who have this highly, highly deadly and dangerous disease.”

Recent Cases Signal a Potential Shift

While the CDC tracks Hib cases, reporting lags can occur. As of March 21, the CDC had logged eight cases this year: two each in Ohio and New York, and one each in Kansas, North Carolina, and Tennessee. Pediatricians are reporting additional cases causing severe illness.

Dr. Kathryn Edwards, a vaccine safety expert at Vanderbilt University Medical Center, noted that her colleagues recently treated two cases of Hib-related meningitis, something Vanderbilt hadn’t seen in “a number of years.” Dr. Eehab Kenawy, a pediatrician in Panama City, Florida, reported that his local hospital’s ICU treated two unvaccinated young children with Hib in December, one of whom tragically died.

A Changing Approach to Diagnosis

The potential resurgence of Hib requires doctors to reconsider their diagnostic approach. “Now I’m not just thinking ‘strep throat, ear infection, upper respiratory infection.’ We have to start thinking about these things as a differential diagnosis in our workup,” explained Dr. Kenawy. “It puts us in a situation where we may have to do more close observation, possibly more admissions, maybe some unnecessary workup at times. It’s the changing world of medicine.”

Understanding Haemophilus influenzae type b

Haemophilus influenzae bacteria are commonly found in the nose and throat and don’t always cause illness. However, Hib can lead to serious infections in the lungs, bloodstream, joints, and epiglottis. The most frightening complication is meningitis – inflammation of the brain and spinal cord.

Dr. Paul Offit, director of the Vaccine Education Center at the Children’s Hospital of Philadelphia, recalls a time when spinal taps were a nightly occurrence due to Hib-related meningitis. “Now pediatric residents in our hospital don’t do spinal taps, which tells you the power of vaccines.”

Vaccination Recommendations and Overall Decline

The CDC recommends three to four Hib shots for all children under age 5, with the full series being at least 93% effective. However, a 2025 NBC News investigation with Stanford University revealed that childhood vaccination rates overall have declined in at least 77% of U.S. counties and jurisdictions since 2019.

Dr. Rana Alissa, president of the Florida chapter of the American Academy of Pediatrics, noted a rise in vaccine hesitancy. “Now we’re almost seeing a free fall.”

A Mother's Plea

Ashlee Dahlberg tragically lost her 8-year-old son, Liam, to Hib last year. Despite being vaccinated, Liam’s immune system was compromised due to asthma treatment. He developed bacterial meningitis and succumbed to the illness within days.

“What I would really love for other people to understand is that there are people out there who are like my son, who have weakened immune systems,” Dahlberg said. “What may be a cold for your child is a death sentence or a hospitalization for another.” She urges families to vaccinate their children to protect vulnerable individuals like Liam.