A thin scar running along the base of Dr. Lara Johnson’s neck is more than a medical remnant; it is a permanent reminder of a disease that once terrorized pediatric wards across the United States. When Johnson was four years old, she contracted Haemophilus influenzae type b, commonly known as Hib, a bacterial infection that attacked her epiglottis—the cartilage that prevents food from entering the windpipe.
The infection caused her airway to close rapidly. Recalling the terror of that moment, Johnson describes a fever and a sensation of choking. She was rushed to Covenant Children’s Hospital in Lubbock, Texas, where she now serves as chief medical officer, for an emergency tracheostomy. Surgeons had to cut through her neck to create an opening in her windpipe so she could breathe. It was 1980, a time before a vaccine for Hib existed.
For decades, the Hib vaccine was one of the great triumphs of public health, turning a once-common killer of infants into a rarity. However, medical professionals are now warning of a potential Hib bacterial disease comeback as childhood vaccination rates slide across the country. Doctors who spent their careers forgetting the sight of a child choking on their own airway are now seeing the disease reappear in their clinics.
The warning signs are appearing in data and in the emergency room. According to the Centers for Disease Control and Prevention (CDC), the percentage of infants who completed the full series of Hib vaccinations fell from 78.8% in 2019 to 77.6% in 2021. While the dip appears slight, epidemiologists fear it marks the beginning of a broader trend of vaccine hesitancy that could leave thousands of children vulnerable to invasive bacterial infections.
According to the CDC, the percentage of babies who got all of their Hib shots fell from 2019 to 2021, from 78.8% to 77.6%. (Joe Amon / The Denver Post via Getty Images file)
(Joe Amon)
The Clinical Danger of Hib
Despite its name, Hib does not cause the seasonal flu. It is a bacterium that can colonize the nose and throat of healthy people without causing symptoms, but it can migrate to the bloodstream or the brain with devastating speed. When the bacteria become invasive, they can cause pneumonia, joint infections, and most dangerously, meningitis—an inflammation of the membranes covering the brain and spinal cord.
For physicians who trained in the late 1970s, the disease was a daily reality. Dr. Paul Offit, a pediatrician and director of the Vaccine Education Center at the Children’s Hospital of Philadelphia, recalls a time when he performed two to three spinal taps a night to diagnose bacterial meningitis in children under age five. Today, many pediatric residents have never performed a lumbar puncture for this purpose, a testament to the vaccine’s success.
The impact of the vaccine is best understood by comparing the era of infection to the era of immunization:
| Metric | Pre-Vaccine Era | Post-Vaccine Era |
|---|---|---|
| Severe Hib Cases | ~20,000 children | Fewer than 50 children |
| Annual Deaths | ~1,000 children | Rare/Sporadic |
| Common Complications | Brain damage, respiratory failure | Preventable via 3-4 dose series |
A ‘Free Fall’ in Vaccination Rates
The resurgence of Hib is not happening in a vacuum. It is part of a wider decline in childhood immunization. A 2025 investigation by NBC News and Stanford University found that overall childhood vaccination rates have dropped in at least 77% of U.S. Counties and jurisdictions since 2019.
This decline is compounded by a growing political climate of skepticism. Robert F. Kennedy Jr., who now serves as the Secretary of Health and Human Services, has frequently questioned vaccine safety and led an effort to overhaul the childhood vaccine schedule—a move that was recently blocked by a federal judge. Dr. Rana Alissa, president of the Florida chapter of the American Academy of Pediatrics, describes the current state of vaccine hesitancy as a “free fall.”
The consequences are already manifesting. As of March 21, the CDC had logged eight cases of Hib this year across Ohio, Modern York, Kansas, North Carolina, and Tennessee. However, pediatricians suggest the official count may lag behind the reality on the ground. Dr. Eehab Kenawy, a pediatrician in Panama City, Florida, noted that in December, his local ICU treated two unvaccinated children with Hib; one was a four-month-old who died.
This shifting landscape is forcing doctors to change how they diagnose common childhood illnesses. When an unvaccinated child presents with a fever or respiratory distress, physicians can no longer assume it is a simple ear infection or strep throat. Hib must now be considered as a “differential diagnosis,” potentially leading to more aggressive testing and hospital admissions.
The Risk to the Vulnerable
One of the most critical aspects of the Hib bacterial disease comeback is the threat it poses to children who are vaccinated but immunocompromised. The concept of herd immunity means that when the majority of a population is vaccinated, the bacteria have nowhere to hide, protecting those whose bodies cannot mount a full immune response.
Ashlee Dahlberg experienced the tragedy of this vulnerability when she lost her 8-year-old son, Liam. Despite being vaccinated, Liam’s immune system was compromised by inhaled steroids used to treat his asthma. What began as a headache and a 103-degree fever rapidly evolved into bacterial meningitis. Within days, MRI scans showed irreversible brain swelling, and Liam was taken off life support.
Ashlee Dahlberg and her son, Liam, who died from bacterial meningitis caused by a Hib infection last April. (Courtesy of Ashlee Dahlberg)
(Courtesy of Ashlee Dahlberg)
Dahlberg now advocates for vaccination not just for the individual child, but for the protection of others. “What may be a cold for your child is a death sentence or a hospitalization for another,” she said.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or vaccination schedule.
Public health officials continue to monitor the rates of Hib and other vaccine-preventable diseases, with the CDC expected to release updated surveillance data as state reporting catches up with current trends. Parents are encouraged to consult the CDC’s recommended immunization schedule to ensure their children are protected.
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