Medicine:DTaP-IPV-HepB vaccine

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Short description: Combination vaccine
DTaP-IPV-HepB vaccine
Combination of
DTaP vaccineVaccine
Inactivated poliovirus vaccineVaccine
Hepatitis B vaccineVaccine
Clinical data
Trade namesPediarix
AHFS/Drugs.comPediarix
MedlinePlusa607014
License data
Pregnancy
category
  • US: C (Risk not ruled out)
Routes of
administration		IM
ATC code
Legal status
Legal status
Identifiers
CAS Number

DTaP-IPV-HepB vaccine is a combination vaccine whose generic name is diphtheria and tetanus toxoids and acellular pertussis adsorbed, hepatitis B (recombinant) and inactivated polio vaccine or DTaP-IPV-Hep B.[1] It protects against the infectious diseases diphtheria, tetanus, pertussis, poliomyelitis, and hepatitis B.[2][3][4]

A branded formulation is marketed in the U.S. as Pediarix by GlaxoSmithKline.[5]

DTaP

The DTaP portion of the vaccine protects against three bacterial infections: diphtheria, tetanus, and pertussis (whooping cough). Diphtheria is a bacterium that causes problems with breathing, heart failure, paralysis, and in some cases death.[6] It is spread via human to human interaction.[6] Tetanus is spread via open cuts or wounds in the body. It can lead to stiffening of the muscles, which can result in difficulties breathing.[6] Pertussis, also known as whooping cough, is the is "aP" portion of the DTaP vaccine.[6] Like diphtheria, it is spread via human to human interaction.[6] With the vaccine, children can build up a supply of antibodies that prevent infection.[7] In general, the DTaP vaccine is only administered to children ages 7 and younger.[6]

IPV

The IPV portion of the DTaP-IPV-HepB vaccine protects against poliomyelitis, otherwise known as polio.[8] IPV stands for inactivated poliovirus vaccine, which means that it does not use a live strand of the polio virus and cannot result in polio.[8] Polio is a life-threatening disease that can cause paralysis, poor muscle function that weakens the ability to breath, and brain problems.[8][9] Since 2016, the United States requires all polio vaccines administered to be IPV and not OPV to eliminate the use of live polio virus.[8]

HepB

The HepB portion of the vaccine protects against hepatitis B. Hepatitis B is a virus that can be spread via mother to child if the mother is infected with hepatitis B, so most doctors recommend that infants be vaccinated.[10] In most individuals infected with hepatitis B, they are asymptomatic.[10] However, symptoms of hepatitis B include flu-like symptoms, diarrhea, and jaundice.[10] Hepatitis B can either be acute or chronic and can ultimately lead to damage of the liver.[10]

Uses

The main reason for the use of combination vaccines is because they require fewer shots. Instead of having a child receive separate shots for each virus they need protection from, scientists were able to create vaccines, like MMR and DTap-IPV-HepB, that protect against several viruses at a time.[11] Another reason is that with the IPV (inactivated poliovirus vaccine) portion of the DTap-IPV-HeB vaccine, children no longer have to take the oral vaccine (OPV) that was administered starting in the 1950s.[12] Although the oral vaccine helped eliminate polio in several countries and is still used in countries today, OPV contains live polio virus and can still result in individuals getting polio.[12][8] Combination vaccines are also more cost effective and make it more likely for children to receive vaccinations.[11][7]  With the DTaP vaccine on its own, it is to be administered in five doses.[6] However, when the DTaP vaccine is administered through the DTaP-IPV-HepB combination vaccine like Pediarix, it only has to be administered in three doses.[13]

Formulations

In general, the DTaP-IPV-HepB vaccine is recommended to be administered in three doses around 8, 12, and 16 weeks old.[9] Talk to your doctor about the vaccine schedule that is best for your child. There are several common DTaP combinations vaccines: Pediarix, Kinrix, and Pentacel.[11] Pediarix combines DTap-IPV-Hep B and Pentacel combines DTaP-IPV-Hib (Haemophilus influenza type b); however, Kinrix only combines DTaP-IPV, which leaves out Hep B and Hib.[11] Therefore, Pediarix and Pentacel are more commonly used because they protect from five rather than four viruses in each dose.[11] For protecting against DTaP viruses, polio, and hepatitis B, Pediarix is the recommended formulation.[11]

Pediarix

Pediarix is vaccine that is protective against diphtheria, tetanus, pertussis, hepatitis B, and polio.[14] This vaccine is FDA approved to be administered to infants in three doses between ages six weeks and six years.[14] Pediarix should not be injected into any child seven years old or older.[14] However, it is recommended that the immunizations be done at months two, four, and six.[15] The wide age gap between six weeks and six years allows for children who fall behind in their vaccinations to still have the opportunity to be vaccinated.[16] From the moment of birth, babies can become infected with these life-threatening diseases, which is why this vaccine is recommended to be given so early on.[9] With these three doses, the Pediarix vaccine has been given to over 8,088 infants.[13] Each does is 0.5mL and is given via intramuscular.[15] For children ages one and younger, the vaccine is injected into the thigh.[15] While for children older than one, it is injected into the deltoid muscle of the arm.[15] Because the Pediarix vaccine has HepB, is it important to note the mother's HBsAg status.[16] Pediarix is recommended for mothers who are HBsAg-negative; however, in 2003 it was approved that children whose mothers are HBsAg-positive can also receive the Pediarix immunization.[16] Looking at overall completed vaccine records, Pediarix completes the amount of HepB doses that an individual needs to be protected.[16] However, boosters are still needed for DTaP and IPV vaccines after the three doses of Pediarix.[16]

DTaP-IPV-HepB virus activity

As of 2021, there were 1,609 cases of pertussis in the United States.[17] The majority of cases were found amongst 6-11 month old children.[17]

References

  1. ↑ "Diphtheria, Tetanus Toxoids, Acellular Pertussis, Hepatitis B (Recombinant), and Poliovirus (Inactivated) Vaccine". Drugs.com. https://www.drugs.com/ppa/diphtheria-tetanus-toxoids-acellular-pertussis-hepatitis-b-recombinant-and-poliovirus-inactivated-vaccine.html. 
  2. ↑ Centers for Disease Control and Prevention (CDC) (March 2003). "FDA licensure of diphtheria and tetanus toxoids and acellular pertussis adsorbed, hepatitis B (recombinant), and poliovirus vaccine combined, (PEDIARIX) for use in infants". MMWR. Morbidity and Mortality Weekly Report 52 (10): 203–204. PMID 12653460. 
  3. ↑ Centers for Disease Control and Prevention (CDC) (October 2008). "Licensure of a diphtheria and tetanus toxoids and acellular pertussis adsorbed and inactivated poliovirus vaccine and guidance for use as a booster dose". MMWR. Morbidity and Mortality Weekly Report 57 (39): 1078–1079. PMID 18830212. 
  4. ↑ "Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices". MMWR. Recommendations and Reports 67 (1): 1–31. January 2018. doi:10.15585/mmwr.rr6701a1. PMID 29939980. 
  5. ↑ "Pediarix". 21 February 2018. https://www.fda.gov/vaccines-blood-biologics/vaccines/pediarix. 
  6. ↑ 6.0 6.1 6.2 6.3 6.4 6.5 6.6 "Diphtheria-Tetanus-Pertussis Vaccine Information Statement | CDC" (in en-us). 27 June 2022. https://www.cdc.gov/vaccines/hcp/vis/vis-statements/dtap.html. 
  7. ↑ 7.0 7.1 "Combination vaccines". Journal of Global Infectious Diseases 3 (1): 63–72. January 2011. doi:10.4103/0974-777X.77298. PMID 21572611. 
  8. ↑ 8.0 8.1 8.2 8.3 8.4 "Your Child's Immunizations: Polio Vaccine (IPV) (for Parents) - Nemours KidsHealth". https://kidshealth.org/en/parents/polio-vaccine.html. 
  9. ↑ 9.0 9.1 9.2 "DTaP/IPV/Hib/HepB vaccine (6-in-1 vaccine)" (in en). https://www.nhsinform.scot/healthy-living/immunisation/vaccines/the-6-in-1-vaccine. 
  10. ↑ 10.0 10.1 10.2 10.3 "Hepatitis B" (in en). https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/hepatitis-b. 
  11. ↑ 11.0 11.1 11.2 11.3 11.4 11.5 "About Combination Vaccines for Children | CDC" (in en-us). 25 May 2022. https://www.cdc.gov/vaccines/parents/why-vaccinate/combination-vaccines.html. 
  12. ↑ 12.0 12.1 "History of polio vaccination" (in en). https://www.who.int/news-room/spotlight/history-of-vaccination/history-of-polio-vaccination. 
  13. ↑ 13.0 13.1 "PEDIARIX Safety Data | PEDIARIX (Diphtheria and Tetanus Toxoids and Acellular Pertussis Adsorbed, Hepatitis B (Recombinant) and Inactivated Poliovirus Vaccine) for Healthcare Professionals" (in en-US). https://www.pediarix.com/efficacy/safety-data/. 
  14. ↑ 14.0 14.1 14.2 Center for Biologics Evaluation and Research (6 November 2019). "PEDIARIX" (in en). FDA. https://www.fda.gov/vaccines-blood-biologics/vaccines/pediarix. Retrieved 16 December 2019. 
  15. ↑ 15.0 15.1 15.2 15.3 "PEDIARIX Administration | PEDIARIX (Diphtheria and Tetanus Toxoids and Acellular Pertussis Adsorbed, Hepatitis B (Recombinant) and Inactivated Poliovirus Vaccine) for Healthcare Professionals" (in en-US). https://www.pediarix.com/for-your-practice/dosing-and-administration/. 
  16. ↑ 16.0 16.1 16.2 16.3 16.4 "Ask the Experts: Combination Vaccines". https://www.immunize.org/askexperts/experts_combo.asp. 
  17. ↑ 17.0 17.1 "State of Pertussis | PEDIARIX (Diphtheria and Tetanus Toxoids and Acellular Pertussis Adsorbed, Hepatitis B (Recombinant) and Inactivated Poliovirus Vaccine) for Healthcare Professionals" (in en-US). https://www.pediarix.com/efficacy/pertussis/. 



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