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1 May 2026Vaccines, immunoglobulins and antiseraSource update: December 2024

Diphtheria, tetanus, pertussis, hepatitis B, Hib vaccine (DTwP-HepB-Hib)

Pentavalent vaccine guidance for prevention of diphtheria, tetanus, pertussis, hepatitis B, and severe Hib infections in children.

This guide page is for structured reference only and does not replace a clinician, pharmacist, or emergency review. Dose choice, route choice, interactions, and safety decisions still need professional judgment.

Indications

Prevention of diphtheria, tetanus, pertussis, hepatitis B, and severe Haemophilus influenzae type B infections in children from 6 weeks to 7 years of age, for primary vaccination.

Composition, forms, route of administration

  • Pentavalent vaccine combining diphtheria toxoid, tetanus toxoid, whole-cell pertussis antigens, hepatitis B surface antigen, and Hib polysaccharide.
  • Suspension for injection in multidose vial, for IM injection into the anterolateral part of the thigh in children under 2 years and into the deltoid muscle in children 2 years and over.
  • Do not administer into the gluteal muscle.
  • Shake before use to homogenise the vaccine.

Dose and vaccination schedule

  • Three-dose primary series: child receives 3 doses 4 weeks apart, preferably before the age of 6 months.
  • Recommended schedule: first dose at 6 weeks, second dose at 10 weeks, and third dose at 14 weeks.
  • If a child has not received the first dose by the age of 1 year, start vaccination as soon as possible according to the 0-1-6 schedule: 2 doses 4 weeks apart, then a third dose 6 months after the first dose.
  • If the vaccine schedule has been interrupted, complete the missing doses and do not restart from the beginning.

Contra-indications, adverse effects, precautions

  • Do not administer in the event of allergic reactions to a previous dose of vaccine containing these strains.
  • Do not administer at birth to vaccinate against hepatitis B.
  • Vaccination should be postponed in the event of severe acute febrile illness; minor infections are not contra-indications.
  • May cause mild local reactions such as redness or pain at the injection site, fever, pain, malaise, headache, myalgia, and rarely anaphylactic reactions.
  • If administered simultaneously with other vaccines, use different syringes and injection sites.
  • Depending on national recommendations, primary vaccination can be done with trivalent, tetravalent, pentavalent, or hexavalent combinations.
  • A booster dose with a vaccine containing at least diphtheria toxoid, tetanus toxoid, and pertussis antigen is recommended between 12 and 23 months of age, with other boosters recommended between 4 and 7 years and 9 and 15 years.

Source

MSF Essential drugs practical guidelines (January 2026)

This page reproduces the structured reference information for this batch while leaving out the Storage and Remarks sections.

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