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Hot topic - New five-in-one vaccine

12 August 2004 - written by Bupa's Health Information Team

The UK Department of Health has announced that a new five-in-one vaccine is to be introduced. Here we explain the changes to the childhood vaccination programme.

What is the new vaccine?

The new vaccine is a combined vaccine against five diseases. These are diphtheria, tetanus, whooping cough (pertussis), polio and the bacterial infection haemophilus influenzae type b (Hib), which can cause pneumonia and meningitis.¹,².

The vaccine is called DTaP/IPV/Hib:

  • D stands for diphtheria
  • T stands for tetanus
  • aP stands for acellular pertussis
  • IPV stands for inactivated polio vaccine
  • Hib stands for haemophilus influenzae type b

When will the new vaccines be introduced?

GP surgeries will receive the new vaccine in late September or early October.¹

What was the previous vaccine?

The previous vaccine, DTwP/Hib, was a four-in one combined vaccine against diphtheria, tetanus, pertussis (whooping cough) and the bacterial infection haemophilus influenzae type B (Hib). ²

In addition to the four-in-one injection, polio vaccine was given by mouth (oral polio vaccine: OPV), as drops of liquid onto the tongue.²

What are the changes?

There are two main changes:

  • Inactivated polio vaccine (IPV) can now be used instead of live oral polio vaccine (OPV).³
  • A new type of whooping cough vaccine is being introduced. This is called acellular pertussis (aP) vaccine. It replaces the whole-cell pertussis (wP) vaccine. Vaccination with the new acellular pertussis provides the same level of protection against whooping cough as whole-cell pertussis vaccine, but is less likely to cause minor side-effects, such as a sore arm.³

Are more vaccines being given?

No, the same number of vaccines are given. Polio will be combined with the injection rather than given separately by mouth. Meningitis C vaccine will continue to be given at the same time, but as a separate injection at a different site.5

Why is inactivated polio vaccine only being used now?

IPV is just as effective as OPV at preventing individuals from getting polio, but less effective at stopping polio spread to other people. This is no longer an issue in the UK, because the risk of polio being imported into the UK is so low. The last case of polio being imported was over ten years ago, because of the success of vaccination programmes.²

When is the new vaccine given?

The new vaccine will be given to babies at the same ages as the current one. Three doses are needed, so the injection is given at two months, three months and again at four months old.

A booster injection is given to children when they are three to five years old. This includes vaccination against diphtheria, tetanus, pertussis and polio (DtaP/IPV).

What are the benefits of the new vaccine?

The polio vaccine is included in the injection and so will not need to be given separately by mouth.

The new vaccine does not contain the substance thiomersal. This is because it cannot be used with inactivated polio vaccine. Thiomersal is a mercury-containing substance that is added to some vaccines to stop them becoming contaminated by bacteria or fungi.4

Thiomersal has a small risk of causing skin reactions, so leaving out thiomersal reduces the risk of a skin reaction at the site of the injection.¹

Also, the UK government has agreed to reduce overall exposure of children to mercury. The type of mercury found in thiomersal-containing vaccines is thought to be safe. However, leaving out thiomersal from vaccines will help meet the aim of reducing children's exposure to any type of mercury wherever possible.³

What are the side-effects of the new vaccine?

Any side-effects of the new vaccine are usually mild. They can include:

  • irritability
  • a slightly high temperature
  • redness or a small lump at the injection site
  • sickness or diarrhoea ²

Less than one in 1000 children has a more severe reaction to the vaccine one or two days after the injection. If any of the following symptoms develop, call your GP immediately:

  • a fit called a febrile convulsion - babies usually recovery quickly from this. (For more information see Bupa's factsheet, Fever in children http://hcd2.bupa.co.uk/fact_sheets/html/fever.html)
  • the baby seems less responsive than usual and floppy
  • a very high temperature
  • an unusual high-pitched cry

It is also possible, though rare, for babies to have a severe reaction immediately after the vaccine is given. Any parent who is concerned about their child's reaction to the vaccine should talk to a GP, nurse or health visitor.

Can all children have the new vaccine?

Most can. However, the vaccine should not be given to children who have had a previous severe reaction to a previous dose of the vaccine or any part of the vaccine. If you are concerned about this, speak to your GP.

Children who are ill and have a high temperature should not be given the vaccine until they have recovered, in case the vaccine makes the fever worse. Children who have a cough or cold but no fever can have the vaccine.²

Can a child's body cope with five vaccines at one time?

Yes. The five-in-one vaccine is a very small challenge to the immune system compared with the thousands of bacteria and viruses that children come into contact with from birth, which the immune system copes with effectively.²

Should my baby have the old vaccine or should I wait until September?

If your baby is due for a vaccination, you should make sure that he or she has the current vaccine.¹

The new and old vaccines are compatible. If your baby had the old vaccine and is due for a second or third injection after September, he or she can have the new vaccine.5

Do the vaccinations work as well when combined?

Yes, the vaccines have been tested and shown to work as well in combination as when given separately.²

Further information

Bupa resources:

External resources:

References

  1. New Childhood Vaccines. 9 August broadcast from Deputy Chief Medical Officer, Department of Health
    http://www.info.doh.gov.uk/doh/embroadcast.nsf/vwDiscussionAll/A31754239537841980256EEB0059BDD2
  2. NHS immunisation information website, accessed on 10 August 2004
    http://www.immunisation.org.uk
  3. NHS press release 9 August 2004: Improvements to childhood immunisation programme
    http://www.immunisation.org.uk/article.php?id=432
  4. NHS immunisation information factsheet: Thiomersal and vaccines
  5. NHS immunisation information: New Vaccines - Questions and answers

 

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