Author: Gauri Kshirsagar
DPT vaccines
*DISCLAIMER: Please note I have mentioned routinely used vaccine brands in INDIA as examples. Please do check the ingredients and discuss in detail with your paediatrician before making a decision. We DO NOT promote any brands. This article is only for information and discussion, NOT an advice column.
The combination of diphtheria, tetanus, and pertussis (DPT) vaccines into a single product has been central to the protection of the pediatric population over the past 50 years. The addition of inactivated polio, Haemophilus influenzae, and hepatitis B vaccines into the combination has facilitated the introduction of these vaccines into recommended immunization schedules by reducing the number of injections required and has therefore increased immunization compliance.
What is the advantage of combination vaccines?
- Fewer Injections
- Reduced trauma to the infant
- Higher rate of compliance with complex vaccine schedules
- Better vaccine coverage
- Timely vaccination – vaccine schedule completed on time
- Reduced administration cost
- Lower storage space requirement
- Allows incorporation of newer vaccines in the schedule
What different types of combinations with DPT which are available in the market?
The commercial vaccines available vary in combinations related to their contents and also differ in costs and side effects.
Combination vaccines are available for
- DPT + Hepatitis B (quadrivalent vaccine)
- DPT + Hepatitis B + Hib vaccine (pentavalent vaccine) e.g.Easy-five® or Pentavac®
- DPT + Hib vaccine + IPV (pentavalent vaccine) e.g.Pentaxim®
What are painless and painful vaccines?
Previously the vaccines at 6, 10 and 14 weeks were each given separately, in which the DPT vaccine was a very painful one. The pain used to last for 24 hours, associated with fever and irritability. DPT vaccine, is now available in “whole cell” and “acellular forms” i.e pertaining to the type of Pertusis agent used (either DPT or DPaT). The acellular vaccine has fewer side effects. Some forums, mention these two different vaccines as “painful” or “painless”. The difference is that, the acellular vaccine will have less pain and lesser side effects like fever or irritability than the cellular one (but it will pain while administering the injection). DPT(painful) combination vaccine is available in the market as Easy-five® or Pentavac®, while DTaP (painless) combination vaccine is called as Pentaxim®.
What is the difference between Easy-five® or Pentavac® AND Pentaxim®
When you go to the health center to get your baby vaccinated, you will be given an option to choose between Easy-five® (Pentavac®) OR Pentaxim® vaccine. Easy-five® and Pentaxim® both give protection against 5 diseases. Let us see how the two differ:
| Easy-five® or Pentavac SD/PFS® |
Pentaxim® |
| Vaccine contains DTP |
Vaccine contains DTaP |
| DTP stands for:
1. Diptheria,
2. Tetanus
3. Pertusis
Easy-five® covers:
1. Diptheria,
2. Pertussis (cellular component), ,
3. Tetanus
4. Haemophilus Influenza type B
5. Hepatitis B. |
DTaP stands for
1. Diptheria,
2. Tetanus
3. Acellular Pertusis
Pentaxim® covers:
1. Diptheria,
2. Pertusis (Acellular Component) ,
3. Tetanus,
4. Haemophilus influenza type B
5. IPV (injectable polio vaccine). |
| Protection offered is similar, but DTP has side-effects like fever and irritability |
DTaP does not have these side-effects. |
| DTP is less expensive.
Easy-five® costs about Rs. 950/- and PentavacSD/PFS® costs about Rs. 500/- |
DTaP is more expensive.
Pentaxim® costs about Rs. 2250/- |
Does the immunization schedule change on the choice of vaccine depending on if its a painless or painful vaccine?
YES!!!!
It is upto you to decide which vaccine to administer depending on all these factors. If you go for Easy-five®, baby should be given injectable polio vaccine, while in case of Pentaxim® hepatitis-B vaccine must administered separately.
The Schedule of the vaccines will change according to brand of vaccine preferred. I personally preferred Pentaxim® vaccine because of easy availability, easy compliance, lesser post vaccination side effects like fever, irritability etc and there is no confusion regarding the Hepatitis B vaccine schedule. Following is an example of how the schedule will vary according to the type of vaccine:
|
Easy-five® or Pentavac SD/PFS® |
Pentaxim® |
| Birth |
1. BCG
2. OPV – Zero Dose
3. Hep B Vaccine – I |
1. BCG
2. OPV – Zero Dose
3. Hep B Vaccine – I |
| 1 Month |
— |
Hepatitis B – 2 |
| 6 Weeks |
1. Pentavac -1
2. IPV -1
3. Rotavirus – 1
4. PCV-1 (Can be given now or after 1 week) |
1. Pentaxim-1
2. Rotavirus- 1
3. PCV-1 (Can be given now or after 1 week) |
| 10 Weeks |
1. Pentavac – 2
2. IPV -2
3. Rotavirus – 2
4. PCV-1 (Can be given now or after 1 week) |
1. Pentaxim -2
2. Rotavirus- 2
3. PCV-2 (Can be given now or after 1 week) |
| 14 Weeks |
1. Pentavac -3
2. IPV -3
3. Rotavirus – 3
4. PCV-3 (Can be given now or after 1 week) |
1. Pentaxim -2
2. Rotavirus- 2
3. PCV-2 (Can be given now or after 1 week) |
| 6 Months |
—– |
Hepatitis B – 3 |
Are there any recent studies that show painful vaccine is better than a painless one?
Yes, there is a recent comparative study (done in 2013) show slight increase in the efficacy of cellular vaccine compared to that acellular vaccine. Please do refer to my blog post: Comparing effectiveness of two types of pertussis vaccines (Cellular and Acellular DPT/DTP Vaccine) for detailed information regarding the same.
Details about the brand names used in this article:
To know about the cost of vaccine in India do read my post: Detailed cost of vaccination/ Immunization in India (Birth to 10 years of age)
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