Abstract and Introduction
Abstract
On December 21, 2018 the Food and Drug Administration (FDA) licensed a hexavalent combined diphtheria and tetanus toxoids and acellular pertussis (DTaP) adsorbed, inactivated poliovirus (IPV), Haemophilus influenzae type b (Hib) conjugate (meningococcal protein conjugate) and hepatitis B (HepB) (recombinant) vaccine, DTaP-IPV-Hib-HepB (Vaxelis; MCM Vaccine Company),* for use as a 3-dose series in infants at ages 2, 4, and 6 months.[1] On June 26, 2019, after reviewing data on safety and immunogenicity, the Advisory Committee on Immunization Practices (ACIP)† voted to include DTaP-IPV-Hib-HepB in the federal Vaccines for Children (VFC) program.§ This report summarizes the indications for DTaP-IPV-Hib-HepB and provides guidance for its use.
Introduction
Combination vaccines merge equivalent component vaccines into a single product to prevent more than one disease. The use of combination vaccines can reduce the number of injections patients receive and improve vaccine coverage rates.[2,3] ACIP has previously stated that the use of a combination vaccine generally is preferred over separate injections of the equivalent component vaccines; considerations can include provider assessment, patient preference, and the potential for adverse events.[4] Until 2018, there were two pentavalent combination vaccines licensed for use in the infant vaccine series: DTaP-HepB-IPV (Pediarix; GlaxoSmithKline) and DTaP-IPV/Hib (Pentacel; Sanofi Pasteur). In late 2018, a new hexavalent combination vaccine (DTaP-IPV-Hib-HepB) from the MCM Vaccine Company, a joint venture between Merck and Sanofi Pasteur, received FDA approval. Each dose of DTaP-IPV-Hib-HepB contains the same amount of diphtheria and tetanus toxoids and pertussis antigens (inactivated pertussis toxin [PT], filamentous hemagglutinin [FHA], pertactin, and fimbriae types 2 and 3) as does Pentacel. The poliovirus component of DTaP-IPV-Hib-HepB contains the same strains of inactivated poliovirus types 1, 2, and 3 as the poliovirus vaccine IPOL (Sanofi Pasteur), but in decreased amounts. The HIB component (Hib capsular polysaccharide polyribosyl-ribotol-phosphate [PRP] coupled to the outer membrane protein complex [OMP] of Neisseria meningitidis) is the same as that in PedvaxHIB (Merck), but in a decreased amount. The HepB component is the same as the pediatric formulation of Recombivax HB (Merck), but in an increased amount. The DTaP-IPV-Hib-HepB vaccine is a fully liquid formulation and requires no reconstitution.
Morbidity and Mortality Weekly Report. 2020;69(5):136-139. © 2020 Centers for Disease Control and Prevention (CDC)
