Pre-school Booster (4-in-1 DtaP/IPV)

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 3500 0
Tetanus 200 0
Pertussis 1000 3
Polio 200 0
TOTAL 4900 3

Source: Public Health England

Key vaccine facts

The Pre-school Booster vaccine used in the UK boosts protection against these four serious diseases: diphtheria, tetanus, whooping cough (pertussis), and polio. Before vaccines existed, these diseases used to kill thousands of children in the UK every year, as the table above shows.

In the UK it is given at around 3 years and 4 months to children who received the initial doses of the vaccines in the first year of life (see the 5-in-1 vaccine for children born on or before 31st July 2017, and the 6-in-1 vaccine for children born on or after 1st August 2017).

It 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. See more about combination vaccines and multiple vaccinations and why these are not a risk to your child's immune system.

The Pre-school Booster vaccine used in the UK does not contain any live bacteria or viruses. It cannot cause any of the diseases it protects against.

Two brands of Pre-school Booster vaccine are used in the UK: Repevax (see the Patient Information Leaflet ) and Infanrix IPV (see the Patient Information Leaflet ). A third vaccine, Boostrix-IPV, is only used for pertussis vaccination in pregnancy.

Ingredients

The Pre-school Booster vaccines used in the UK for children are called Repevax and Infanrix IPV. Apart from the active ingredients (the antigens), they contain very small amounts of these ingredients:

  • Aluminium, which strengthens and lengthens the immune response to the vaccine
  • Polysorbate, used as an emulsifier to hold other ingredients together (Repevax only)
  • A very small amount of phenol, used as a preservative (Repevax only)
  • Medium 199 (containing amino acids, mineral salts and vitamins), used as a stabiliser (Infanrix IPV only)
  • Sodium chloride (salt) (Infanrix IPV only)

In addition, Pre-school Booster vaccines may contain tiny traces of these substances used in the manufacturing process:

The polio part of both vaccines is grown in the laboratory using animal cell strains. See more information on animal cell strains in vaccine production.

Other brands of Pre-school Booster vaccines used in other countries may contain different ingredients. If you are not in the UK, ask for the Patient Information leaflet for the vaccine you are offered.

Side effects

Very common (affecting more than 1 in 10 people at each dose):

  • pain, redness and swelling at the injection site
  • temperature of 38°C or higher
  • feeling irritable or restless
  • tiredness or feeling sleepy
  • loss of appetite
  • unusual crying
  • headache

Common (affecting up to 1 in 10 people at each dose):

  • feeling sick or being sick (nausea or vomiting)
  • diarrhoea
  • temperature of 39.5°C or higher
  • hard lump at the injection site
  • itching or skin inflammation in the area where the vaccine was injected
  • generally feeling unwell or weak
  • aching or swollen joints

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).

Very rare (affecting fewer than 1 in 10,000 people at each dose):

  • 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 your child experiences fits or HHE episodes 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. For more information on febrile seizures generally, see NHS Choices .

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.

If you are concerned about any reactions that occur after vaccination, consult your doctor. In the UK you can report suspected vaccine side effects to the Medicines and Healthcare products Regulatory Agency (MHRA) through the Yellow Card Scheme . You can also view data on Yellow Card reports for individual products . See more information on the Yellow Card scheme and monitoring of vaccine safety.

More information about the vaccine

The full name of the Pre-School Booster vaccine is DTaP/IPV, which stands for ‘Diphtheria, Tetanus, acellular Pertussis and Inactivated Polio Vaccine’.

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 section on '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 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).

Page last updated: 
Monday, August 13, 2018

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