DTaP

The DTaP portion of the vaccine protects against three viruses: diphtheria, tetanus, and pertussis (whooping cough). Diphtheria is a virus that causes problems with breathing, heart failure, paralysis, and in some cases death. ^[1] It is spread via human to human interaction. ^[1] 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. ^[1] Pertussis, also known as whooping cough, is the is “aP” portion of the DTaP vaccine. ^[1] Like diphtheria, it is spread vis human to human interaction. ^[1] With the vaccine, children can build up a supply of antibodies that prevent infection. ^[2] In general, the DTaP vaccine is only administered to children ages 7 and younger. ^[1]

IPV

The IPV portion of the DTaP-IPV-HepB vaccine protects against poliomyelitis, otherwise known as polio. ^[3] IPV stands for inactivated poliovirus vaccine, which means that is does not use a live strand of the polio virus and cannot result in polio. ^[3] Polio is a life threatening disease that can cause paralysis, poor muscle function that weakens the ability to breath, and brain problems. ^{[3] [4]} Since 2016, the United States of America requires all polio vaccines administered to be IPV and not OPV to eliminate the use of live polio virus. ^[3]

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 Hep B, so most doctors recommend that infants be vaccinated. ^[5] In most individuals infected with Hepatitis B, they are asymptomatic. However, symptoms of Hep B include flu-like symptoms, diarrhea, and jaundice. ^[5] Hep B can either be acute or chronic and can ultimately lead to damage of the liver. ^[5]

Why Use Combination Vaccines?

The main reason for the use of combination vaccines is because they require less 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. ^[6] 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. ^[7] 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. ^{[7] [3]} Combination vaccines are also more cost effective and make it more likely for children to receive vaccinations. ^{[6] [2]} With the DTaP vaccine on its own, it is to be administered in five doses. ^[1] 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. ^[8]

Formulations of the DTaP-IPV-HepB Vaccine

In general, the DTaP-IPV-HepB vaccine is recommended to be administered in 3 doses around 8, 12, and 16 weeks old. ^[4] 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. ^[6] 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. ^[6] Therefore, Pediarix and Pentacel are more commonly used because they protect from five rather than four viruses in each dose. ^[6] For protecting against DTaP viruses, polio, and hepatitis B, Pediarix is the recommended formulation. ^[6]

Pediarix

Pediarix is vaccine that is protective against diphtheria, tetanus, pertussis, hepatitis B, and polio. ^[9] This vaccine is FDA approved to be administered to infants in three doses between ages six weeks and six years. ^[9] Pediarix should not be injected into any child seven years old or older. ^[9] However, it is recommended that the immunizations be done at months two, four, and six. ^[10] 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. ^[11] 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. ^[4] With these three doses, the Pediarix vaccine has been given to over 8,088 infants. ^[8] Each does is 0.5mL and is given via intramuscular. ^[10] For children ages one and younger, the vaccine is injected into the thigh. While for children older than one, it is injected into the deltoid muscle of the arm. ^[10] Because the Pediarix vaccine has HepB, is it important to note the mother’s HBsAg status. ^[11] 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. ^[11] Looking at overall completed vaccine records, Pediarix completes the amount of HepB doses that an individual needs to be protected. ^[11] However, boosters are still needed for DTaP and IPV vaccines after the three doses of Pediarix. ^[11]

DTaP-IPV-HepB Virus Activity

As of 2021, there were 1,609 cases of Pertussis in the United States of America. ^[12] The majority of cases were found amongst 6-11 month old children. ^[12]