Diphtheria with tetanus, pertussis, poliomyelitis and Hib vaccine

How it works

Diphtheria and tetanus toxoids, acellular pertussis components, inactivated poliovirus and a conjugated Hib polysaccharide together stimulate protective antibody responses.

Prescribing in practice

• Defer in any infant with anaphylaxis to a previous dose or component and obtain specialist advice for an unstable neurological condition before pertussis-containing vaccine.
• Give by intramuscular injection as part of the primary course; apnoea has been reported in very premature infants after immunisation and may require monitoring of the first dose.
• Postpone for acute febrile illness but proceed despite minor intercurrent infection.

Monitoring

Observe for immediate allergic reactions, watch very preterm infants for apnoea after the first dose, and advise on common transient reactions.

Counselling the patient

• Mild fever and a sore leg or arm are expected and settle quickly.
• Report any high fever or severe reaction promptly.
• Attend all appointments so the schedule is completed on time.

Evidence & guidelines

DTaP/IPV/Hib combinations are used for primary childhood immunisation within the UK schedule as set out in national guidance (the Green Book).