Immunisation Dtp Polio Hep B And Hib

Overview

The 6-in-1 vaccine is a single injection that protects babies against six serious infections at once: diphtheria, tetanus, whooping cough (pertussis), polio, hepatitis B and Hib (Haemophilus influenzae type b). It is given to babies in the first few months of life, when they are most vulnerable to these illnesses. The vaccine contains killed (inactive) or harmless parts of the germs, so it cannot cause the diseases it protects against. Instead, it teaches your baby's immune system to recognise and fight those germs if they ever meet them for real.

Yes. This vaccine is offered to every baby as part of the routine childhood schedule, so your nurse or doctor will be very used to giving it. Millions of babies receive it each year.

Babies from around 8 weeks old, and young children when they have their pre-school booster. Some adults also need boosters against one or more of these diseases — for example during pregnancy, for certain jobs, or before travelling to places where these illnesses are more common.

Symptoms

Common symptoms

• A sore, red or slightly swollen area on the thigh where the injection went in
• A mild temperature (slightly raised body heat)
• Being more fussy or unsettled than usual
• Being sleepier than usual, or sometimes more wakeful
• Feeding a little less than normal for a day
• A small hard lump at the injection site that can last a few weeks

Symptoms in children

• Crying more than usual, especially in the first few hours
• Wanting extra cuddles and comfort
• Being off their food for a day
• A red, warm patch on the leg that slowly fades
• Temporary swelling of the whole thigh happens occasionally and settles on its own

Symptoms in older adults

• This vaccine is mainly for babies and young children. When older children or adults need a booster of one of these vaccines, a sore arm and a mild temperature for a day or two are the usual effects.

Causes

Main causes

• This page is about a vaccine, not an illness, so it does not have 'causes' in the usual sense. The vaccine works by showing your baby's immune system a safe version of each germ.
• Diphtheria, tetanus, whooping cough and Hib are caused by bacteria. Polio and hepatitis B are caused by viruses.
• These germs spread easily between people — through coughs and sneezes, or through contact with an infected person. Babies have not yet built up protection, which is why vaccination starts so early.

Risk factors

• Being very young — babies under 6 months are at the highest risk of severe complications from whooping cough and Hib
• Not being vaccinated, or having only part of the course
• Being born prematurely, which can make some infections more serious
• Living with a condition or receiving treatment that weakens the immune system (your doctor will advise on timing)
• Travel or close contact with people from areas where these diseases are more common

When to see a doctor

See a doctor urgently if:

• Your baby has a fever of 38°C or above and is under 3 months old
• Your baby has a fit, becomes floppy, or is very difficult to wake
• Your baby's breathing seems different — fast, noisy or laboured
• There is severe swelling of the leg or the redness is spreading quickly
• Your baby has a high-pitched, inconsolable cry for several hours

Book a routine appointment if:

• You are worried about any reaction, even a mild one — it is always fine to ask
• Your baby missed a dose or you are not sure what is next in the schedule
• Your baby was unwell on the day of the appointment, or has a long-term condition
• You have questions about the ingredients, or about vaccines in general
• A lump at the injection site is still there after a few weeks

Diagnosis

There is nothing to diagnose here — this is a protective vaccine, not a test for an illness. Before the injection, the nurse or doctor will ask a few quick questions about your baby's health and check they are well enough to have it that day.

Tests that may be done

• No blood tests or scans are needed
• The nurse will check your baby's temperature and general health on the day
• Your baby's personal health record (often a red book) is updated so the doses are recorded correctly

What to expect at your appointment

The appointment is short. The nurse will ask about any illness or allergies, explain what is being given, and then give the injection into your baby's thigh — this is the safest spot for a baby. Your baby will probably cry briefly. You can feed or cuddle them straight afterwards. You will be given advice on what to expect and when the next dose is due. Sometimes several vaccines are given at the same visit, in different legs.

Treatment

No treatment is needed after the vaccine — it is doing its job. Any mild reactions can be eased at home with comfort and, if needed, advice from a pharmacist or nurse about suitable fever and pain relief for your baby's age.

Self-care at home

• Give plenty of cuddles and keep your baby close
• Offer extra feeds — babies who feed well tend to settle better
• Dress your baby in light, comfortable clothing if they feel warm
• Do not rub or massage the injection site
• A cool (not cold) cloth on the leg can be soothing if your baby seems to like it
• Keep a note of the time and dose of any fever medicine you give, so you do not give more than recommended
• Never give aspirin to a child under 16

Medical treatments

If your baby seems uncomfortable or has a mild temperature, ask your pharmacist, nurse or doctor which pain and fever relief is suitable for your baby's age and weight, and follow their advice carefully. Your surgery can also advise if you are unsure whether a reaction is normal. Severe allergic reactions are treated in hospital with emergency medicines, but this is extremely rare.

Living with this condition

Life carries on as normal after the injection. Your baby can be fed, cuddled, bathed and taken out as usual. Many parents find the first 24 hours are the fussiest, and things settle quickly after that. Keeping your appointments and your baby's health record up to date makes the whole schedule much easier to manage.

Lifestyle tips

• Keep a simple record of each vaccine, with the date, so you always know what is next
• Try to book appointments at a time when your baby is usually calm and well rested
• Bring a favourite blanket, toy or dummy to the appointment for comfort
• If your baby is due other vaccines at the same visit, it is fine to ask which is which
• Hand-washing and keeping away from people with coughs and colds also helps protect young babies

Diet and exercise

No special diet is needed. Continue your baby's usual milk feeds, and offer extra feeds if they seem unsettled or warm. Normal play and movement are fine — there is no need to rest the leg. For older children, ordinary running about is encouraged.

Mental health and emotional wellbeing

It is very common for parents to feel anxious before their baby's injections, and hearing your baby cry can be upsetting. Those feelings are normal and usually pass quickly. If worry about vaccines is weighing on you, or you have had a difficult experience, talk it through with your health visitor, nurse or doctor. They will not judge you — they would much rather answer your questions. If low mood or anxiety is affecting your daily life, please reach out for support, and remember that crisis support is available in every country if you ever feel you cannot cope.

Prevention

Yes — vaccination is one of the most effective ways to prevent these six diseases. When enough babies are vaccinated, the germs have nowhere to spread, which also protects newborn babies who are too young to be vaccinated and people who cannot have vaccines for medical reasons.

Vaccines

The 6-in-1 vaccine is usually given at 8, 12 and 16 weeks of age, with a booster before your child starts school (around 3 years and 4 months). Some babies with certain health conditions are offered an extra dose at birth or later. Whooping cough vaccine is also offered in pregnancy, which passes protection to the newborn baby before their own vaccines start. Ask your nurse or doctor about the exact schedule where you live, and about catch-up doses if you have missed any.

Complications

If left untreated

• Whooping cough causes severe coughing fits and pauses in breathing in babies, and can be life-threatening in the first few months of life
• Hib can cause meningitis (swelling around the brain) and epiglottitis (a dangerous swelling of the throat that blocks breathing)
• Diphtheria can block the airway and damage the heart and nerves
• Tetanus causes painful muscle stiffness and spasms, and can be fatal
• Polio can cause permanent weakness or paralysis
• Hepatitis B can lead to long-term liver damage and liver cancer
• Not being vaccinated also leaves other people at risk, especially newborn babies and those who cannot be protected themselves

Long-term outlook

The outlook for a vaccinated child is excellent. These vaccines have been used for decades and have made these diseases rare in many parts of the world. If your baby has a mild reaction, it passes quickly and is a sign the immune system is learning. If you have missed doses, it is not too late — catch-up vaccination works well, so talk to your nurse or doctor about getting back on track.

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