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TOKYO — As military hospitals waited last week for more supplies of the HIB vaccine, health officials said the risk to unimmunized children in Asia is unclear but much less than for children living in other parts of the world.

Military doctors said going without the immunization can cause increased risk of a bacterial infection called haemophilus influenzae Type B.

But they also said the risk is minimal for children in South Korea and Japan where, historically, rates of the infection have been lower than in other parts of the world.

A December recall of the vaccine by manufacturer Merck & Co. has made the injection scarce and has forced some hospitals to ration it.

At some hospitals in South Korea and Japan, the supply is either expended or so low that providers are limiting doses to children 12 months and younger, military officials said.

According to the National Network for Immunization Information, children should get the vaccine at 2 months, 4 months and sometimes 6 months, depending on the brand, with a booster shot between 12 and 15 months.

Worldwide, the infection causes about 3 million serious illnesses and an estimated 386,000 deaths per year.

Most cases are in "resource-poor" countries, according to the World Health Organization.

Of the 3 million illnesses each year, nearly all victims are under 5, according to Maj. Remington Nevin, a doctor and acting chief for preventive medicine at United States Army Medical Activity-Korea.

Before the vaccine was universally administered in the United States, rates of infection inside America were among the highest in the world, Nevin said.

Now that U.S. health care providers issue the vaccine to children, the infection’s spread to unimmunized children is less likely, health officials have said. Officials in South Korea say this "herd immunity" helps protect small portions of a population that miss immunizations.

It’s unclear, however, how strong the herd immunity phenomenon might be in Japan and South Korea.

A pediatrics medical consultant at the Sohwa Children Hospital in Seoul said 90 percent of parents decide to vaccinate their children with HIB because of meningitis concerns. But Nevin said his contacts at the Korean Center for Disease Control and Prevention said the vaccine is not universally administered.

In Japan, officials approved use of the vaccine in early 2007, but no manufacturer has begun selling it, according to Japan’s health ministry.

Military doctors said while the vaccine is important, nonimmunized children can still attend day care or pre-school. They also said postponing the immunization should not affect a child’s lifelong immunity.

Cmdr. Craig Martin, a pediatrician at U.S. Naval Hospital Yokosuka in Japan, said parents do not need to take any special precautions for an unimmunized infant outside of routine hygiene.

If a child does run a fever, parents should tell health care providers the child has not been immunized, Martin said.

This report was compiled by Stars and Stripes reporters Jennifer Svan, Hana Kusumoto, Hwang Hae-rym and Teri Weaver


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