5-in-1 Vaccine (DTaP/IPV/Hib)

The impact of vaccination

The table below shows the average number of deaths in the UK each year, before and after introduction of a vaccine:

Disease Before After
Diphtheria 4000 0
Tetanus 200 0
Pertussis 1500 3
Polio 700 0
Hib Disease 30 0
TOTAL 6430 3

Source: Public Health England

Key vaccine facts

The 5-in-1 vaccine gives protection against these five serious diseases: diphtheria, tetanus, whooping cough (pertussis), polio and Hib disease (Haemophilus influenzae type b). Before vaccines existed, these diseases used to kill thousands of children in the UK every year, as the table above shows.

The 5-in-1 vaccine is given at 2, 3 and 4 months in the UK schedule. The repeated doses are needed to give a good immune response in most children. The vaccine can safely be given at the same time as other vaccines in the schedule (see the full UK routine schedule for details of the other vaccines). It is a combination vaccine, which reduces the number of injections a child needs. Read more about combination vaccines and multiple vaccinations and why these are not a risk to your baby's immune system.

The 5-in-1 vaccine does not contain any live bacteria or viruses. It cannot cause any of the diseases it protects against.

The current vaccine contains just 12 antigens (the active ingredients that make the immune system produce antibodies to protect you against the disease). The vaccine used until 2004 contained about 3,000 antigens. This means that the current vaccine is less likely to cause side effects. See 'More information' below.

Ingredients

The 5-in-1 is a conjugate vaccine. Individual sugars (polysaccharides) from the bacteria are joined to a protein (in this case, a non-toxic protein from tetanus). This is done because the sugars alone do not produce a good immune response in infants and children.

Apart from the active ingredients (the antigens), the vaccine contains very small amounts of these ingredients:

  • Sodium chloride (salt)
  • Lactose and Medium 199 (containing amino acids, mineral salts and vitamins), both used as stabilisers
  • Polysorbate, used as an emulsifier (to hold other ingredients together)
  • A small amount of aluminium, which strengthens and lengthens the immune response to the vaccine. See more information on aluminium in vaccines.
  • A very small amount of phenol, used as a preservative.

The polio part of the vaccine is grown in the laboratory using animal cell-lines. See more information on animal cell-lines in vaccine production.

The 5-in-1 vaccines used in the UK do not contain the preservative thiomersal (mercury).

Side effects

Common but not serious:

  • redness, tenderness and/or swelling at the injection site
  • raised temperature (fever)
  • irritability
  • sickness
  • diarrhoea
  • loss of appetite

Many of these symptoms can be relieved by giving paracetamol (Calpol)if your child is over 2 months, or ibuprofen if your child is over 3 months and weighs more than 5kg (see NHS Choices for more advice on giving painkillers to babies and children).

More serious side effects are very rare:

  • high temperatures, sometimes leading to fits (also called convulsions or febrile seizures)
  • unusual high-pitched screaming and hypotonic-hyporesponsive episodes (HHE), during which the child may become blue, pale and/or limp.

You should consult your doctor if these happen after vaccination. This is mainly to check that it is the vaccine causing the symptoms, and not some unrelated disease. Symptoms such as fits can be very worrying for parents, but there is no evidence of long-term effects. Children can normally safely receive vaccines in the future.

As with any vaccine, medicine or food, there is a very small chance of a severe allergic reaction (anaphylaxis). Anaphylaxis is different from less severe allergic reactions because it causes life-threatening breathing and/or circulation problems. It is always serious but can be treated with adrenaline. In the UK between 1997 and 2003 there were a total of 130 reports of anaphylaxis following ALL immunisations, but all of these people survived. Around 117 million doses of vaccines were given in the UK during this period, making the overall rate around 1 in 900,000. Depending on the cause of the reaction, and following expert guidance, the person may be able to have vaccinations in the future.

Reactions listed under ‘possible side effects’ or ‘adverse events’ on vaccine product information sheets may not all be directly linked to the vaccine. See Vaccine side effects and adverse reactions for more information on why this is the case.

See more information on the monitoring of vaccine safety.

More information about the vaccine

The full name of the 5-in-1 vaccine is DTaP/IPV/Hib, which stands for ‘Diphtheria, Tetanus, acellular Pertussis, Inactivated Polio Vaccine, Hib (Haemophilus influenzae type b)’.

The vaccine includes the acellular pertussis vaccine (the ‘aP’ in ‘DTaP’). This uses only those parts of the pertussis (whooping cough) bacteria needed to produce an immune response. This greatly reduces the chance of serious side effects such as high temperatures, screaming episodes, and HHE (see side effects above). The whole cell (wP) vaccine used in the UK until 2004 contained many more antigens and had a greater risk of side effects.

The 5-in-1 vaccine also includes inactivated polio virus (IPV). As this is inactivated, it cannot cause polio (which was a very small risk with the live, oral polio vaccine used in the UK until 2004).

Different countries have decided on different schedules for the 5-in-1 vaccine. In the UK, the three doses are given as close together as possible to give babies early protection from pertussis (whooping cough). This disease can be particularly severe in very young babies, so the earlier they are protected the better. This 'accelerated' programme was introduced in the UK in 1990, and led to a drop in the number of pertussis cases.

The immunisation rate in the UK for the three doses of the 5-in-1 vaccine has been around 94% since 2001, just below the World Health Organization target of 95%. However, rates are lower than 94% in some areas of the UK. For example, in London in 2014 the coverage rate was around 90%, and in some parts of London the rate was below 75%.

Deciding whether to give the whooping cough vaccine

In this film, Julia Lamming talks about deciding whether to give the whooping cough vaccine to her baby daughter who had suffered from neonatal fits. Dr Matthew Snape from Oxford Vaccine Group explains how the vaccine itself has changed, and that babies with an identified and stable neurological condition can safely receive the vaccine.

Page last updated: 
Thursday, September 1, 2016

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