RT Journal Article SR Electronic T1 Management of patients with an inadequate haemophilus influenzae type b antibody response JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP PA5030 DO 10.1183/13993003.congress-2015.PA5030 VO 46 IS suppl 59 A1 White, S.M. A1 Davies, H.E. YR 2015 UL https://publications.ersnet.org//content/46/suppl_59/PA5030.abstract AB Introduction: Haemophilus influenzae type b (Hib) may cause respiratory and systemic disease; it is associated with COPD exacerbation. Hib vaccination is advised in children, and in adults at risk of invasive disease.Aims: To assess (i)physician action following request of Hib antibody levels and (ii)the effect of vaccination on patient outcome.Methods: 573 respiratory patients had specific Hib antibody assays between 01.06.2011 and 31.05.2013. Hospital data on 47.8% (n=274) with an inadequate baseline response were reviewed. Patients were divided into responders (normal response to vaccination) and non-responders (< doubling of baseline and/or value <1.0mcg/ml). Patients' wellbeing was assessed via telephone interview and number of antibiotic courses prescribed pre- and post-vaccination.Results: 49.6% (n=136) with an inadequate baseline antibody response were not vaccinated. Of those who were 105 (38.3%) were true responders. Of the 33 patients with an inadequate 2nd antibody level only 18 had been re-vaccinated (true non-responders). 13/18 patients were re-tested, 4 had an inadequate 3rd assay post 2nd vaccination. Responders (post vaccination)Non-responders (post vaccination)Subjective respiratory health (%)Number of antibiotic courses (%)Subjective respiratory health (%)Number of antibiotic courses (%)Improved36.454.421.421.4No change54.527.357.235.7Worse9.118.221.442.9Conclusion: Physician action is poor following detection of an inadequate Hib antibody response. Vaccination responders may have reduced need for antibiotics and improved symptoms compared to non-responders. Exploration of these findings is needed.