Adult Dosing
Pediatric Dosing
Immunization
- 6 wks-6 yrs
- 0.5 mL IM x 3 at 2, 4, and 6 months of age at intervals of 6-8 wks, preferably 8 wks
- Notes:
- May administer the first dose as early as 6 wks of age
- These three doses constitute a primary immunization course for diphtheria, tetanus, pertussis, and poliomyelitis and the complete vaccination course for hepatitis B
- Do not administer intravenously, intradermally, or subcutaneously
- Administer in the anterolateral aspect of the thigh for children <1 yr and in the deltoid muscle for older children
- Do not inject in the gluteal area or areas where there may be a major nerve trunk
Modified schedules in previously vaccinated children
- Previous vaccination with Diphtheria and Tetanus Toxoids and Acellular Pertussis Vaccine Adsorbed (DTtaP)
- Diphtheria/tetanus/acellular pertussis/hepatitis B/poliovirus-inactivated vaccine may be used to complete the first three doses of DTaP series in children who have received 1-2 doses of Infanrix (Diphtheria and Tetanus Toxoids and Acellular Pertussis Vaccine Adsorbed) and are also scheduled to receive the other vaccine components of diphtheria/tetanus/acellular pertussis/hepatitis B/poliovirus-inactivated vaccine
- Previous vaccination with hepatitis B vaccine
- Diphtheria/tetanus/acellular pertussis/hepatitis B/poliovirus-inactivated vaccine may be used in children born of HBsAg-negative mothers who are also scheduled for receiving the other vaccine components of this vaccine for completing the hepatitis B vaccination series following 1-2 doses of another hepatitis B vaccine (monovalent or as part of a combination vaccine), including vaccines from other manufacturers
- A 3-dose series of diphtheria/tetanus/acellular pertussis/hepatitis B/poliovirus-inactivated vaccine may be used in infants born of HBsAg-negative mothers and who have received a dose of hepatitis B vaccine at or shortly after birth
- Previous vaccination with Inactivated Poliovirus Vaccine (IPV)
- Diphtheria/tetanus/acellular pertussis/hepatitis B/poliovirus-inactivated vaccine may be used for completing the first 3 doses of the IPV series in children who have received 1-2 doses of IPV from a different manufacturer and are also scheduled for receiving the other vaccine components of this vaccine
Booster immunization following diphtheria/tetanus/acellular pertussis/hepatitis B/poliovirus-inactivated vaccine
- Complete the DTaP and IPV series in children who have received a 3-dose series with diphtheria/tetanus/acellular pertussis/hepatitis B/poliovirus-inactivated vaccine
- Administer Infanrix (diphtheria/tetanus toxoids and acellular pertussis vaccine) as their fourth dose of DTaP and either Infanrix or Kinrix (diphtheria/tetanus toxoids/acellular pertussis adsorbed/poliovirus, inactivated vaccine) as their fifth dose of DTaP in these children
- Use Kinrix or another manufacturer’s IPV to complete the 4-dose IPV series
[Outline]
See Supplemental Patient Information
- Administration of diphtheria/tetanus/acellular pertussis/hepatitis B/poliovirus-inactivated vaccine in infants is associated with higher rates of fever, compared to separately administered vaccines
- On development of Guillain-Barré syndrome within 6 wks following administration of vaccine containing tetanus toxoid, carefully consider potential benefits and possible risks before administration of diphtheria/tetanus/acellular pertussis/hepatitis B/poliovirus-inactivated vaccine or any vaccine containing tetanus toxoid
- Use of syringes containing natural rubber latex or dry natural latex rubber may be associated with allergic reactions in latex sensitive individuals
- Following administration of diphtheria/tetanus/acellular pertussis/hepatitis B/poliovirus-inactivated vaccine syncope (fainting) may occur accompanied by transient neurological signs such as visual disturbance, paresthesia and tonic-clonic limb movements
- Following administration of a vaccine containing a pertussis component, if the patient develops temperature
40.5oC (105oF) within 48 hours not due to another identifiable cause, collapse or shock-like state within 48 hrs; persistent, inconsolable crying lasting 3 hrs within 48 hrs and seizures with or without fever within 3 days, carefully consider potential benefits and possible risks before administration of any pertussis-containing vaccine - Administer an appropriate antipyretic at the time of vaccination in children at high risk for seizures, and for the ensuing 24 hrs to reduce the possibility of post-vaccination fever
- Apnea may occur in certain premature infants following IM vaccination. Consider the infant’s medical status and the potential benefits and possible risks of vaccination before administration of an intramuscular vaccine in premature infants
- Obtain the patient's immunization history for possible vaccine sensitivity and previous vaccination-related adverse reactions prior to administration of this vaccine as it will help to assess benefits and risks. On occurrence of an acute anaphylactic reaction, immediately administer epinephrine and other appropriate agents
Cautions: Use cautiously in
- History of reactions with pertussis vaccine
- Premature infants
- CNS disorder
- Risk of seizure
- Acute illness
- Immunosuppressed patients
Supplemental Patient Information
- Inform the parent or guardian of the importance of completing the immunization series
Pregnancy Category:C
Breastfeeding: Vaccines administered to a nursing mother do not affect the safety of breastfeeding for mothers or infants and breastfeeding is not a contraindication to DTP vaccine. Women who have not received acellular pertussis vaccine with tetanus and reduced diphtheria toxoids (Tdap) previously should be vaccinated with Tdap as soon as feasible in the postpartum period, even if they are breastfeeding, as long as they have not been vaccinated with tetanus and reduced diphtheria toxoids (Td) vaccine within the past 2 years. The injectable polio vaccine is inactivated and poses no risk when given to mothers who are breastfeeding. Hepatitis B vaccine is safely administered directly to newborn infants. Breastfeeding also reduces infant side effects associated with routine childhood immunization. Vaccinate breastfed infants according to the routine recommended schedules. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/ht mlgen?LACT last accessed 11 August 2011).
