5-in-1 Vaccine (also called Pentavalent Vaccine)

Vaccine

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This page is about the 5-in-1 vaccine used in the UK until 2017. Other countries may use a different version of the 5-in-1 vaccine. If you are not from the UK please check which vaccine is used in your country, as the information here may not apply to you. See 'More information about the vaccine' at the bottom of the page.

The 5-in-1 vaccine was used in the UK for many years. In late September 2017 the UK replaced it with a 6-in-1 vaccine for all babies born on or after 1st August 2017. Both vaccines give protection against diphtheria, tetanus, whooping cough (pertussis), polio and Hib disease (Haemophilus influenzae type b). Before vaccines existed, these diseases used to kill thousands of children in the UK every year (see the table in 'More information about the vaccine' at the bottom of the page). The 6-in-1 vaccine also gives protection against hepatitis B, a cause of serious liver disease.

The 5-in-1 vaccine was given to all UK babies born on or before 31st July 2017. It was given at 2, 3 and 4 months in the UK. The 5-in-1 vaccines used in the UK do not contain any live bacteria or viruses and cannot cause any of the diseases they protect against.

Two brands of 5-in-1 vaccine were used in the UK: Pediacel and Infanrix IPV+Hib (see the Patient Information Leaflet).

 

Apart from the active ingredients (the antigens), the 5-in-1 vaccines used in the UK contain very small amounts of these ingredients:

  • A small amount of aluminium, which strengthens and lengthens the immune response to the vaccine. See more information on aluminium in vaccines.
  • Sodium chloride (salt)
  • Polysorbate, used as an emulsifier (to hold other ingredients together)
  • Lactose and Medium 199 (containing amino acids, mineral salts and vitamins), both used as stabilisers (Infanrix IPV+Hib only)
  • A very small amount of phenol, used as a preservative (Pediacel only).

The Hib part of the 5-in-1 is a conjugate vaccine. Sugars are taken from the capsule around the Hib bacteria are joined to a non-toxic protein from tetanus. The protein helps to stimulate the immune system in a broader way to respond well to the vaccine. This gives a better immune response in individuals of all ages.

The polio part of the vaccine is grown in the laboratory using animal cell strains. See more information on animal cell strains in vaccine production.

Other brands of 5-in-1 vaccine used in other countries may contain different ingredients. If you are not in the UK, ask for the Patient Information leaflet for the vaccine you are offered.

 

Common (affecting up to 1 in 10 people at each dose):

  • redness, tenderness and/or swelling at the injection site
  • raised temperature (fever)
  • irritability
  • sickness
  • diarrhoea
  • loss of appetite

Many of these symptoms can be relieved by giving paracetamol (Calpol)if your child is over 2 months, or ibuprofen if your child is over 3 months and weighs more than 5kg (see NHS Choices for more advice on giving painkillers to babies and children).

Rare (affecting up to 1 in 1000 people at each dose):

  • high temperatures, sometimes leading to fits (also called convulsions or febrile seizures)
  • unusual high-pitched screaming and hypotonic-hyporesponsive episodes (HHE), during which the child may become blue, pale and/or limp.

You should consult your doctor if these happen after vaccination. This is mainly to check that it is the vaccine causing the symptoms, and not some unrelated disease. Symptoms such as fits can be very worrying for parents, but there is no evidence of long-term effects. Children can normally safely receive vaccines in the future. For more information on febrile seizures generally, see NHS Choices.

As with any vaccine, medicine or food, there is a very small chance of a severe allergic reaction (anaphylaxis). Anaphylaxis is different from less severe allergic reactions because it causes life-threatening breathing and/or circulation problems. It is always serious but can be treated with adrenaline. In the UK between 1997 and 2003 there were a total of 130 reports of anaphylaxis following ALL immunisations, but all of these people survived. Around 117 million doses of vaccines were given in the UK during this period, making the overall rate around 1 in 900,000. Depending on the cause of the reaction, and following expert guidance, the person may be able to have vaccinations in the future.

Reactions listed under ‘possible side effects’ or ‘adverse events’ on vaccine product information sheets may not all be directly linked to the vaccine. See Vaccine side effects and adverse reactions for more information on why this is the case.

See more information on the monitoring of vaccine safety.

 

The full name of the 5-in-1 vaccine used in the UK is DTaP/IPV/Hib, which stands for ‘Diphtheria, Tetanus, acellular Pertussis, Inactivated Polio Vaccine, Hib (Haemophilus influenzae type b)’.

The table below shows the average number of deaths in the UK each year, before and after introduction of a vaccine:

Disease Before After
Diphtheria 3500 0
Tetanus 140 0
Pertussis 1000 3
Polio 200 0
Hib Disease 60 0
TOTAL 4900 3

Source: Public Health England and the Health Protection Agency archive

The vaccine includes the acellular pertussis vaccine (the ‘aP’ in ‘DTaP’). This uses only those parts of the pertussis (whooping cough) bacteria needed to produce an immune response. This reduces the chance of serious side effects such as high temperatures, screaming episodes, and HHE (see section on 'Side effects' above). The whole cell (wP) vaccine used in the UK until 2004 contained many more antigens and had a greater risk of side effects.

The 5-in-1 vaccine used in the UK also includes inactivated polio virus (IPV). As this is inactivated, it cannot cause polio (which was a very small risk with the live, oral polio vaccine used in the UK until 2004).

Different countries have decided on different schedules for the 5-in-1 vaccine, based on different patterns of disease. In the UK, the three doses were given as close together as possible to give babies early protection from pertussis (whooping cough). This disease can be particularly severe in very young babies, so the earlier they are protected the better. This 'accelerated' programme was introduced in the UK in 1990.

The immunisation rate in the UK for the three doses of the 5-in-1 vaccine has been around 94% since 2001, just below the World Health Organization target of 95%. However, rates are lower than 94% in some areas of the UK. For example, in London in 2014 the coverage rate was around 90%, and in some parts of London the rate was below 75%.

 

Some countries such as India use a different version of the 5-in-1 vaccine. This is often called 'pentavalent vaccine'. This vaccine usually protects against a slightly different set of diseases to the 5-in-1 vaccine used in the UK: diphtheria, whooping cough (pertussis), tetanus, hepatitis B and Hib disease (Haemophilus influenzae type b). The polio vaccine is then usually given separately as a live oral vaccine. The other main difference between this 5-in-1 vaccine and the one used in the UK is that it contains whole-cell pertussis vaccine (wP) rather than acellular pertussis vaccine (aP). Whole-cell pertussis vaccine is made using killed whole pertussis bacteria and may lead to a greater risk of side effects such as high fever and seizures (fits). Acellular pertussis vaccine is made using only parts of the pertussis bacteria and has a lower risk of side effects.

If you are not from the UK please check which vaccine is used in your country, as the information on this page may not apply to you.

 

Page last updated Monday, September 9, 2019