diphtheria, tetanus, pertussis (acellular), poliomyelitis (inactivated), hepatitis b (rDNA) and haemophilus influenzae type b (Hib) vaccine: prescribing and clinical use
Focused clinical detail for use alongside current product information, local policy and patient-specific assessment.
diphtheria, tetanus, pertussis (acellular), poliomyelitis (inactivated), hepatitis b (rDNA) and haemophilus influenzae type b (Hib) vaccine: clinical details
Prescribing considerations
- Review vaccination history, previous adverse events, allergies and neurological history.
- Postpone during acute severe febrile illness; minor infection alone is not a contraindication.
- Use caution with thrombocytopenia or bleeding disorders because administration is intramuscular.
- Immunosuppression may reduce immunogenicity.
- Consider respiratory monitoring in very premature infants, particularly with previous respiratory immaturity.
- Record the product name and batch number.
Contraindications and cautions
- Hypersensitivity to an active substance, excipient, formaldehyde, neomycin or polymyxin.
- Hypersensitivity after a previous diphtheria, tetanus, pertussis, hepatitis B, polio or Hib vaccine.
- Encephalopathy of unknown cause occurring within seven days of a previous pertussis-containing vaccine.
Monitoring
- Ensure facilities and trained personnel are available to manage anaphylaxis.
- Consider clinical observation where previous pertussis-containing vaccination was associated with high fever, a hypotonic-hyporesponsive episode, prolonged inconsolable crying or convulsions.
- Urinary Hib antigen testing may be transiently positive after vaccination; confirm suspected infection using other tests.
- Monitor fever risk when co-administering vaccines known to increase reactogenicity.
Clinical pharmacology
A combined adsorbed vaccine that induces active humoral immunity against toxoids and specific bacterial or viral antigens. Its hepatitis B component uses recombinant DNA technology, its polioviruses are inactivated, and its Hib polysaccharide is conjugated to tetanus toxoid.
Formulation and product differences
- Infanrix hexa comprises Hib powder in a vial and DTaP-IPV-HepB suspension in a pre-filled syringe, combined immediately before administration.
- Shake the suspension until homogeneous and use only if its appearance is normal after reconstitution.
- It contains aluminium adjuvants, lactose, very small amounts of phenylalanine and para-aminobenzoic acid, and trace manufacturing residues of formaldehyde, neomycin and polymyxin.
- It must not be mixed with other medicinal products in the same preparation.
diphtheria, tetanus, pertussis (acellular), poliomyelitis (inactivated), hepatitis b (rDNA) and haemophilus influenzae type b (Hib) vaccine interactions
Relevant considerations include other vaccines and treatments that suppress immune function.
Immunosuppressive therapy
The immune response may be weaker, although immunosuppression is not itself a contraindication to this non-live vaccine.
Pneumococcal conjugate vaccines
They may be given at the same visit, but fever can occur more often than with Infanrix hexa alone.
Meningococcal B vaccine
Concomitant administration can increase fever, injection-site pain, irritability and reduced appetite, particularly when a pneumococcal vaccine is also given.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.