Diphtheria with tetanus, pertussis, hepatitis B, poliomyelitis and Hib vaccine

How it works

It presents toxoids, acellular pertussis components, hepatitis B surface antigen, inactivated poliovirus and a conjugated Hib polysaccharide to induce protective antibodies against all six targets.

Prescribing in practice

• Do not give to an infant with a confirmed anaphylactic reaction to a previous dose or component, and seek advice for an evolving neurological disorder before the pertussis-containing vaccine.
• It is the routine primary course given by intramuscular injection in infancy and is co-administered with other scheduled vaccines such as meningococcal, pneumococcal and rotavirus per the schedule.
• Apnoea has been reported after immunisation in very premature infants, so the first dose in this group may warrant respiratory monitoring.

Monitoring

Observe for immediate hypersensitivity, monitor very preterm infants for apnoea after the first dose, and advise on expected local and febrile reactions.

Counselling the patient

• Mild fever and injection-site soreness are common; paracetamol may be advised around the routine infant doses.
• Seek help for a high fever or any severe reaction.
• Keep all scheduled appointments to complete the primary course.

Evidence & guidelines

The hexavalent six-in-one vaccine forms the basis of the UK primary infant immunisation schedule as described in national guidance (the Green Book).