diphtheria, tetanus, pertussis (acellular), hib vaccine and poliomyelitis: prescribing and clinical use
Focused clinical detail for use alongside current product information, local policy and patient-specific assessment.
diphtheria, tetanus, pertussis (acellular), hib vaccine and poliomyelitis: clinical details
Prescribing considerations
- Confirm previous vaccine history and reactions.
- Postpone during acute severe febrile illness; a minor infection alone is not a contraindication.
- Carefully assess further pertussis-containing vaccination after a temporally associated collapse episode, unexplained very high fever, prolonged inconsolable crying or convulsion.
- Consider respiratory monitoring in very premature infants, particularly with previous respiratory immaturity.
- Use caution with thrombocytopenia or bleeding disorders; apply firm pressure without rubbing afterward.
- The Hib component does not protect against other Haemophilus influenzae types or meningitis from other organisms.
Contraindications and cautions
- Hypersensitivity to an active component, excipient, formaldehyde, neomycin or polymyxin
- Hypersensitivity following a previous diphtheria, tetanus, pertussis, polio or Hib vaccine
- Encephalopathy of unknown cause occurring shortly after a previous pertussis-containing vaccine
Monitoring
- Ensure treatment and supervision for anaphylaxis are immediately available.
- Record the product name and batch number.
- Anticipate a potentially reduced response in immunodeficiency or during immunosuppressive treatment.
- Hib antigen may temporarily cause a false-positive urinary antigen result.
Clinical pharmacology
The toxoids, purified acellular antigens, inactivated polioviruses and conjugated Hib polysaccharide induce active humoral immune responses. Aluminium hydroxide acts as an adsorbent adjuvant; pharmacokinetic assessment is not applicable to vaccines.
Formulation and product differences
- Supplied as a DTPa-IPV suspension in a pre-filled syringe and separate lyophilised Hib powder requiring reconstitution.
- Contains no hepatitis B component, unlike the hexavalent vaccines routinely used for NHS infant immunisation.
- May contain traces of formaldehyde, neomycin and polymyxin; also contains lactose, phenylalanine and para-aminobenzoic acid.
- Must be refrigerated, protected from light and never frozen.
diphtheria, tetanus, pertussis (acellular), hib vaccine and poliomyelitis interactions
Important practical interactions include:
Immunosuppressive medicines
The immune response may be reduced, although this does not automatically prevent vaccination.
Other injectable vaccines
They may be given at the same visit but must be injected at separate sites.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.