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 4000 0
Tetanus 200 0
Pertussis 1500 3
Polio 700 0
TOTAL 6400 3

Source: Public Health England

Key vaccine facts

This vaccine 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.

It is given at 3 years and 4 months in the UK schedule, to children who received the initial doses of the vaccines in the first year of life (see 5-in-1 DTaP/IPV/Hib vaccine).

It can safely be given at the same time as other vaccines in the schedule (for more on this, see multiple vaccinations).

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 child's immune system.

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


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 vaccine may contain traces of neomycin, streptomycin and polymyxin B, which are all antibiotics used in the production process. See more information on antibiotics in vaccines. It may also contain tiny traces of formaldehyde or glutaraldehyde, used during the manufacturing process to inactivate the viruses in the vaccine.

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 Pre-school Booster vaccine used in the UK does not contain the preservative thiomersal (mercury).

Side effects

The following reactions are common but not serious:

  • redness, tenderness and/or swelling at the injection site
  • slightly raised temperature
  • 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 reactions 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 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 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: 
Wednesday, January 11, 2017



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