diphtheria, tetanus, pertussis (acellular) and poliomyelitis (inactivated): prescribing and clinical use
Focused clinical detail for use alongside current product information, local policy and patient-specific assessment.
diphtheria, tetanus, pertussis (acellular) and poliomyelitis (inactivated): clinical details
Prescribing considerations
- Review primary immunisation history, previous vaccine reactions and current programme eligibility.
- Defer during acute severe febrile illness; a minor infection alone is not a contraindication.
- Assess bleeding risk and take precautions against injury from syncope.
- Immunosuppression may reduce immunogenicity; protection is not guaranteed in every recipient.
- Have treatment and supervision immediately available for rare anaphylaxis.
Contraindications and cautions
- Hypersensitivity to vaccine antigens, excipients or relevant manufacturing residues.
- Previous hypersensitivity after a diphtheria-, tetanus-, pertussis- or poliomyelitis-containing vaccine.
- Encephalopathy of unknown cause occurring soon after an earlier pertussis-containing vaccine.
- Boostrix-IPV is additionally contraindicated after specified transient thrombocytopenia or neurological complications following earlier diphtheria or tetanus immunisation.
Monitoring
- Record the product name and batch number.
- Inspect the suspension before use and monitor for immediate allergic reactions and injection-related syncope.
- Advise reporting significant or unexpected suspected adverse reactions through the Yellow Card scheme.
Clinical pharmacology
Diphtheria and tetanus toxoids, purified acellular pertussis antigens and inactivated poliovirus antigens on aluminium-containing adsorbents induce humoral immune responses and immune memory. Pharmacokinetic assessment is not applicable to vaccines.
Formulation and product differences
- REPEVAX and Boostrix-IPV are cloudy white suspensions in pre-filled syringes, but their pertussis-antigen composition, antigen quantities, adsorbents and excipients differ.
- REPEVAX contains phenoxyethanol, ethanol and polysorbate 80 and may contain specified trace manufacturing residues.
- Boostrix-IPV contains small quantities of para-aminobenzoic acid and phenylalanine and may contain traces of formaldehyde, neomycin and polymyxin.
diphtheria, tetanus, pertussis (acellular) and poliomyelitis (inactivated) interactions
Tell the vaccinator about all medicines, vaccines and immune treatments.
Immunosuppressants, systemic corticosteroids or chemotherapy
The immune response may be reduced, although this does not usually create an infection risk because the vaccine is non-live.
Anticoagulants or medicines affecting clotting
Intramuscular injection may increase bruising or bleeding, so suitability and administration technique require assessment.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.