Diphtheria, Tetanus, Acellular Pertussis, Hepatitis B, and Polio Vaccine (Intramuscular)

Pertussis, tetanus toxoids, diphtheria, poliovirus and hepatitis B vaccine in combination are given in childhood to provide protection from these diseases in later life. Children under seven years of age are given this vaccine, spaced over three separate doses.

Overview

Pertussis, tetanus toxoids, and diphtheria (DTP vaccine), and poliovirus and hepatitis B vaccine (IPV and HepB) are combined into one vaccine and sold in the US under the brand name, Pediarix.

The combination immunizing agent triggers the body into making antibodies that are resistant to all five of the diseases covered by the vaccine. Pediarix provides protection against:

Both vaccines that are included in the combination medicine contain inactive forms of the bacterial toxins that can cause the diseases. Inactive bacteria are no longer disease triggering, but they do stimulate the recipient's body into making antibodies that provide immunity against the active toxins.

Children aged between six weeks and seven years of age are given the vaccine in three doses on three separate occasions.

The diseases that are prevented by this vaccine have all but died out in most of the developed world thanks to the discovery of vaccines and antibiotics. However, these diseases are still prevalent in less developed countries, and it is therefore especially important that your family is fully protected if you are intending to travel abroad to areas where these conditions are still rife.

Diphtheria:

Diphtheria is a potentially fatal disease that causes heart problems, breathing difficulties, nerve damage, and pneumonia. The disease is more serious in the very young and elderly.

Tetanus (lockjaw)

Tetanus is a very serious disease that causes severe seizures and muscle spasms. In some cases, the spasms can be so strong that a fractured spine can result. Tetanus is also called lockjaw, as one of the most common signature symptoms is paralysis of the muscles around the jaw and windpipe. In such cases, the victim may die from suffocation.

Tetanus bacteria lives in soil and manure, entering the body through cuts and open sores. Therefore, people who work or have hobbies that involve being in such an environment are more likely to contract tetanus.

The illness generally only affects people who have not been vaccinated.

Pertussis (whooping cough)

Whooping cough causes severe coughing and breathing difficulties. It can also cause chronic bronchitis, convulsions, pneumonia, and brain damage. Pertussis can be fatal, especially in very young babies and children.

Hepatitis B

Hepatitis B causes a number of serious liver diseases, including cancer. Hepatitis B is transmitted through bodily fluids, commonly either through sexual contact or shared needles. This disease can be passed from a pregnant woman to her unborn baby, leading to potential serious health problems.

Polio

Polio is an incurable disease that can cause muscle paralysis. Some sufferers are left unable to walk without leg callipers, potentially finishing up wheelchair bound, or needing to remain on a ventilator, as the muscles that enable them to breathe are no longer effective.

The vaccine may only be given to your child by a doctor or other trained medical professional and is administered via an injection into the muscle.

Conditions treated (prevented)

Type of medicine

  • Immunizing agent
  • Intramuscular injection
  • Solution

Side effects

Together with the effect it is designed to have, a vaccine sometimes causes unwanted side effects. Your child may not have any of these effects, but if they do become apparent, you may need to take your child to see a doctor. You must mention any side effects that your child experiences to these vaccines, even if the effects resolve themselves. Some side effects mean that it is not safe for your child to have the other vaccinations in the series.

If any of the following effects are noticed, mention them to your GP or nurse immediately:

  • Jaundice
  • Wheezing
  • Weight loss
  • Vomiting or vomiting of blood
  • Unusual tiredness or weakness
  • Unusual bleeding or bruising
  • Unpleasant breath odor
  • Breathing difficulties
  • Tightness of the chest
  • Swelling
  • Sudden Infant Death Syndrome (SIDS)
  • Swelling or stiffness
  • Stiff neck
  • White spots, sores, or ulcers, on the lips or around the mouth
  • Sore throat
  • Skin rash
  • Shortness of breath
  • Seizures
  • Skin redness
  • Irritated, red eyes
  • Red pinpoint skin spots
  • Pain or cramps in the stomach or abdomen
  • Nausea
  • Mood changes
  • Loosening of the skin
  • Joint pain
  • Itching
  • Puffiness, itchiness, or swelling of the eyes, eyelids, lips, face, or eyes
  • Irritability
  • Hoarseness
  • Hives on the face, lips, tongue, throat, genitals, legs, hands, or feet
  • Headache
  • Hallucinations
  • Fever
  • Fast heartbeat
  • Drowsiness
  • Dizziness
  • Difficulty swallowing
  • Diarrhea
  • Dark urine
  • Cyanosis
  • Cough
  • Confusion
  • Coma
  • Collapse or shock-like state
  • Clay colored stools
  • Chills
  • Blurred vision
  • Blood in the urine or stools
  • Bleeding gums
  • Black, tarry stools
  • Back pain
  • Agitation
  • Abdominal or stomach ache

Some of the following side effects will disappear of their own volition without needing any further medical treatment as your child's body gets used to the vaccine. Your GP may have some ideas on how you can manage or prevent some of the more common side effects. If the effects become problematic or very persistent, ask your doctor for advice.

  • Warmth of the skin
  • Unusual crying
  • Ulceration
  • Tingling or stinging sensations
  • Thinning of hair
  • Tenderness
  • Tender, swollen, or painful, lymph glands in the groin, neck, or armpit
  • Soreness
  • Sneezing
  • Sleeping more than usual
  • Restlessness
  • Reddening of the neck, face, arms, and occasionally, upper chest
  • Paleness of skin
  • Joint pain
  • Numbness
  • Muscle pain, stiffness, or weakness
  • Lumps
  • Loss of energy or strength
  • Loss of appetite
  • Lack or loss of strength
  • Itching skin
  • Inflammation
  • Infection
  • Hair loss
  • General feeling of illness or discomfort
  • Fussiness
  • Feeling of warmth
  • Feeling of pressure
  • Dullness, weakness, tiredness, or feeling of sluggishness
  • Discoloration of skin
  • Difficulty moving
  • Coldness
  • Burning
  • Blistering
  • Bleeding
  • Arm or leg swelling

The side effects mentioned above are not necessarily the only ones that have been noted. If your child reports any other effects, you should contact your GP.

Dosage

Vaccines can only be given to children by a trained nurse or another medical professional. Your doctor may give the vaccine to your child, or your child's school may run a vaccination program where a qualified nurse will administer the drug. The vaccine will be given as an injection into a muscle, usually in the thigh or shoulder. This vaccine comes as a course of three separate doses. The first can be given when the child is six weeks old, the second four months later, and the final dose six months following the first dose.

It is safe for the child to be given other vaccines at the same time as this one, but they must be in different body areas. You will be given information sheets about all of the medication that your child is given. Read the information and make sure that you understand it all. Your GP may also give you some medication for your child that can be useful in tackling some of the minor side effects that the vaccine could cause.

For the vaccine to be fully effective in protecting your child, it is very important that your child receives all the doses in the series. Be sure to attend all your child's scheduled GP appointments. If you do miss an appointment, make another one as soon as you can so that your child does not miss a dose of the vaccine.

Interactions

Some drugs must never be used together as a serious interaction may occur. However, it is safe to use some medicines at the same time, despite the interaction. In such circumstances, your GP may change the dose of one or more of the drugs or recommend precautions you could take. Before your child is given this vaccine, make sure that you tell your GP if any other drugs are being used.

Note that having this vaccine with either of the following vaccines can present a higher risk of some side effects, although your doctor may decide that this is the best treatment for your child.

  • Tetanus toxoid conjugate quadrivalent
  • Meningococcal vaccine

Some drugs should not be used at the same time as eating food. Be sure to discuss this with your child's GP. In addition, smoking can affect how some medicines work. If someone in your child's household smokes, mention this to your GP too.

Medical history

Some existing or historical health conditions can affect how this vaccine works. Be sure to discuss your child's medical history fully with your GP, before your child is vaccinated.

This vaccine should not be used in children who have suffered encephalopathy following a vaccination with pertussis.

In children suffering from a moderate or severe illness where a fever is one of the symptoms, this vaccine can increase the likelihood of side effects.

If your child has a history of contracting Guillain-Barre syndrome following a vaccination with tetanus vaccine, you should discuss the potential risks and benefits of giving your child this vaccine.

If your child has an immunodeficiency disorder, this vaccine may not be as effective.

If your child has suffered side effects following a vaccination with pertussis or any other vaccine containing pertussis, you should discuss with your GP the risks and benefits of proceeding with this vaccine.

If, following this vaccine, you notice that your child is less responsive than usual, cries without stopping for over three hours, has convulsions, or has a fever of over 1050F you should consult your GP immediately. This could indicate a serious allergic reaction to the vaccine.

This vaccine should not be given to children who suffer from progressive neurological disorders, including infantile spasms, brain disease, or epileptic fits until the conditions are fully controlled.

Warnings

When considering whether or not to have your child vaccinated, you must discuss with your GP the benefits of doing so against the risks of not doing so. During these discussions, you should tell your doctor if your child has any allergies or has reacted badly to any other form of vaccine. You should also mention any bad reactions the child has had to any particular food groups, food dyes, preservatives, or animal derivatives.

Note that this vaccine should not be given to babies less than six weeks old or to children over the age of seven. This vaccine should not be given to adult patients.

You must take your child back to your GP surgery for their second and third doses of the vaccine. Always tell your GP about any side effects that might recur after the child receives a dose of the vaccine.

If the child comes out in a rash, hives, or develops any other allergic skin reaction following this vaccine, tell your GP immediately.

If your child has already received part of a series of vaccinations, be sure to tell your doctor, as this vaccine could be used in order to complete a series of inoculations that have already been started.

One of the prefilled dosage devices that is used with this vaccine contains latex rubber. For this reason, you must tell your child's GP if the child has a sensitivity to latex.

In premature babies, this vaccine can cause breathing difficulties. Your GP will decide if it is appropriate and safe for your child to receive this vaccine.

This vaccine is not designed to treat an active infection. Therefore if your child has active tetanus, diphtheria, hepatitis B, pertussis, or polio, you must tell your doctor so that a suitable medication with which to treat the illness can be prescribed.

If you child exhibits any serious side effects after having the vaccine, you must tell your GP. Such effects include fainting, crying continually, seizures, a high fever, swelling or severe reddening around the vaccination site.

Storage

It is unlikely that you will need to store this drug in your home as your child will receive the vaccine from a trained medical professional. However, if you do have cause to keep this vaccine for home use, you should keep it in its original container, at room temperature, and in a place where it cannot be exposed to direct sunlight or heat. Do not place the vaccine in the fridge or freezer.

Do not use vaccine that has gone out of date. Use a fresh, sterile needle and syringe for every vaccination, including boosters.

Dispose of unused vaccines responsibly. The best course of action is to return the unused solution to your GP or pharmacy for safe, correct disposal. Do not place needles, syringes, or vaccine solution in the trash. Use a proper sharps bin to dispose of used needles.

Summary

Pertussis, tetanus toxoids, and diphtheria (DTP), and poliovirus and hepatitis B vaccines (IPV and HepB) are used in combination under the US brand name, Pediarix. The vaccine is an immunizing agent that stimulates the body into creating antibodies that provide effective resistance against tetanus, diphtheria, whooping cough, polio, and hepatitis B.

The vaccine must be given in a series of three shots, the earliest begin given when the child is six weeks of age. The vaccine is not suitable for use in adults or in children over seven years of age. Your child will be vaccinated by a medical professional, either at your doctor's clinic or in school as part of a vaccination program.

There are a number of side effects that may affect your child after they have been given their first shot. As there are two more vaccinations in the course, it is important that you mention any ill effects to your GP before the other shots are due. There may be measures that you can take to prevent the side effects next time around. In the event that your child suffers very serious side effects, your GP may recommend an alternative vaccine.

It is important that you discuss your child's medical history fully with your doctor, before the vaccine is given, as there are a number of medical conditions that can be made worse by the vaccine or which may cause serious side effects.