A dose of DTaP/IPV(polio)/Hib vaccine is offered at age two, three and four months (the primary course). A booster of Hib is offered at around 12 months. At age 3 years and four months to 5 years a 'pre-school booster' of DTaP/IPV(polio) (without Hib) is offered. 10 years after that a 'school leaver booster' of just Td/IPV(polio) (without Hib or pertussis) is offered. Pregnant women are also offered DTaP/IPV(polio) between 28 and 38 weeks of pregnancy.
What is the DTaP/IPV(polio)/Hib vaccine?
DTaP stands for diphtheria (D), tetanus (T) and acellular pertussis (aP) (whooping cough). Polio is short for poliomyelitis. IPV stands for 'inactivated polio vaccine'. Hib stands for Haemophilus influenzae type b. The vaccines to protect against these five diseases are combined into one injection.
This is a combination vaccine which does not contain any live germs (organisms) so cannot cause any of the diseases it is protecting against.
Before 2004, polio vaccine used to be given as drops into the mouth. Polio vaccine is now always given as an injection.
Timetable for DTaP/IPV(polio)/Hib immunisation
- Babies are offered the 'primary course' of DTaP/IPV(polio)/Hib. This consists of a first dose of vaccine at the age of two months. Then a second dose four weeks later at the age of three months. Then a third dose four weeks later at the age of four months.
- Each dose of the primary course of DTaP/IPV(polio)/Hib is usually given at the same time as the meningitis C (MenC) vaccine and/or the pneumococcal conjugate vaccine (PCV) (given with separate injections).
- A booster fourth dose of Hib is offered at between 12 and 13 months. This is combined with the MenC vaccine as a single injection.
- A booster dose of DTaP/IPV(polio) (without the Hib) is offered three years after the third dose of the primary course (at age 3 years and four months to 5 years). This is a 'pre-school' booster. It is usually given at the same time as the measles, mumps and rubella (MMR) 'pre-school' booster (which is given by a separate injection).
- A booster dose of tetanus/diphtheria and polio (Td/IPV(polio) - without whooping cough (pertussis) or Hib - is also offered at age 13-18. This is sometimes called the teenager or 'school leaver' booster.
If your child has not had their routine immunisations at the correct time, they can usually 'catch up'. Doses and timings of 'catch-up' can vary, depending on age and previous immunisations. Your doctor or practice nurse will advise you about this.
Since September 2012 the DTaP/IPV(polio) vaccine has also been offered to all pregnant women between 28 and 38 weeks of pregnancy. This vaccination programme aims to boost the short-term immunity passed on by pregnant women to their newborn babies who normally cannot be vaccinated themselves until they are two months old.
Who should NOT receive DTaP/IPV(polio)/Hib vaccine?
- The vaccine should not be given if you have had a severe reaction to a previous dose. Also, if you have had a previous severe (anaphylactic) reaction to neomycin, streptomycin or polymyxin B, as tiny amounts of these antibiotics may be present in very small amounts in the vaccine.
- A dose of vaccine may be delayed if your child is ill with a high temperature (fever).
- There is no reason to delay a dose of vaccine if your child has a minor infection, such as a cough, cold or snuffles.
Premature babies should still have the vaccines.
Are there any side-effects from the DTaP/IPV(polio)/Hib vaccine?
- Slight swelling and redness at the injection site are common.
- A little area of hard skin may form at the injection site, which usually disappears in time.
- Sometimes, a high temperature (fever) occurs a few hours after the injection and the child may become irritable.
- Serious reactions are extremely rare.
If necessary, you can give a child paracetamol or ibuprofen to ease any pain and fever if your child seems distressed. Occasionally, a baby may cry or be irritable for a few hours following immunisation. If this appears to be extreme, or lasts for more than a few hours, you should seek a doctor's advice.
How serious are the diseases prevented by DTaP/IPV(polio)/Hib vaccine?
Diphtheria is a serious infection of the throat and lungs caused by the germ (bacterium) Corynebacterium diphtheriae. The bacteria also make a poison (toxin) which can affect the heart and nervous tissue. The introduction of this immunisation in 1940 reduced this illness dramatically. In the UK, diphtheria is now extremely rare.
Tetanus is an infection caused by a bacterium called Clostridium tetani. It is a serious illness which can attack the muscles and nervous system. It can be very serious and even result in death. The bacteria which cause tetanus live in the soil. Most infections are caught from cuts, particularly dirty wounds. Even tiny cuts, such as thorn scratches, can introduce the tetanus bacteria into the body. Tetanus is not transmitted from person to person and needs a cut in the skin to get into the body. Tetanus in the UK is uncommon and occurs mainly in people over the age of 65 years who have not been previously immunised against tetanus, as the immunisation was introduced in the 1950s.
Whooping cough (pertussis)
Whooping cough is a highly infectious disease caused by a bacterium called Bordetella pertussis. It is passed from person to person by coughing. It causes a distressing and prolonged coughing illness which can lead to complications causing pneumonia, brain damage and even death. Before immunisation was introduced there were often over 100,000 cases per year in England and Wales. After it was introduced in the 1950s, the rate fell dramatically. There are around 3,000 cases of pertussis a year in the UK.
Polio is a serious illness caused by the polio virus. The virus first infects the gut but then travels to the nervous system and can cause a meningitis-like illness. This can sometimes leave permanent damage to some nerves. This can lead to wasting of some muscles and can sometimes cause paralysis of the arms or legs. The illness can seriously affect breathing in some people and may lead to death. In 1955, before the introduction of polio immunisation, there were nearly 4,000 reported cases of polio in England and Wales. Polio is now extremely rare in the UK because of the success of immunisation.
Different types of the haemophilus bacterium cause infections such as ear infections and chest infections. However, Haemophilus influenzae type b (Hib) is a particularly nasty type. This can cause meningitis and a very serious disease of the throat (called epiglottitis). It can also cause infective arthritis, infection in bones and pneumonia. Serious illnesses caused by Hib are uncommon under the age of three months. Unless immunised, they become more common towards the first birthday. After the age of 4 years they become uncommon again. So, the 'at-risk' time for infections caused by Hib is from three months to 4 years.
Further reading & references
- Immunisation against infectious disease - the Green Book (latest edition); Public Health England
- The routine immunisation schedule from summer 2015; NHS England
- Whooping Cough Vaccination Programme for Pregnant Women; Dept of Health, 2012
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.
Dr Tim Kenny
Dr Louise Newson
Prof Cathy Jackson