dTaP/IPV (4 in 1) vaccine - About the 4 in 1 vaccine

The 4-in-1 is given to children when they are 3 years and 4 months old. This vaccine boosts the protection from the 6-in-1 vaccines they had as babies (which included protection against diphtheria, tetanus, whooping cough, polio, Haemophilus influenzae type b (Hib) and hepatitis B).

The ‘4-in-1’ vaccine is also offered in some occupational health circumstances.

You should cancel an appointment if you can’t make it. If you do miss the appointment or have to delay the vaccination, make a new appointment as soon as possible. The vaccination can still be given, but your child will be without protection for longer.

Remember, it’s important to catch up on missed vaccinations. If your child has missed a vaccination and is older than the recommended age for it, talk to your GP, practice nurse or health visitor.

Contact a GP or visit the nearest minor injury or emergency department if you’re concerned about a wound, particularly if:

• it’s a deep wound
• there’s dirt or something inside the wound, or
• your child is not fully vaccinated for tetanus, or you’re not sure.

‘Wound’ includes burns to the skin and tissue beneath.

A doctor or nurse will assess the wound and decide if your child needs a tetanus vaccine.

If you have any questions about the 4-in-1 vaccine, or you are not sure about when it should be given, contact your GP surgery for advice.

Very few children cannot have the 4-in-1 vaccination. The vaccine should not be given to children who have had a severe (life-threatening) allergic reaction to:

• any ingredient in the vaccine, or
• a previous dose of the vaccine.

Speak to your GP, practice nurse or health visitor before your child has the vaccination if your child:

• has a bleeding disorder (such as haemophilia, where their blood does not clot properly), or
• has ever had a seizure (fit) that wasn’t caused by a fever.

The ‘4-in-1’ vaccine currently available in the UK is known under the brand names Boostrix-IPV and REPEVAX.

If your child has missed an appointment for the ‘4-in-1’ vaccination speak to your GP or practice nurse for advice.

You can find information about other vaccinations against diphtheria, tetanus, pertussis and polio on the following pages:

• 6-in-1 vaccine
• 3-in-1 vaccine
• Whooping cough (pertussis) vaccination

The practice nurse or GP will explain about the vaccinations and answer your questions. In children over the age of 12 months, injections are usually given in the upper arm.

Write down any questions you have and ask the health professional at the vaccination appointment.

Millions of doses of the vaccine have been given and it has a very good safety record.

Like all medicines, vaccines can cause side effects. Most of these are mild and do not last long, and not everyone gets them.

Vaccine side effects are minor compared to getting seriously ill from the diseases.

The most common side effects include:  

• pain, redness or swelling at the injection site
• tiredness
• diarrhoea, and
• fever.

Very rare side effects from the vaccine include:  

• allergic reactions, such as swelling of the face, lips, tongue or throat, hives (a raised, itchy rash), difficulty breathing or swallowing, and feeling dizzy.

Rarely, people can have a severe reaction soon after the vaccination, which causes breathing difficulties and may cause them to collapse. This is called an anaphylactic reaction, and it can also happen with other medicines and food. These reactions are extremely rare, affecting less than one in a million people. Staff who give vaccinations are trained to manage these reactions.

People who have an anaphylactic reaction can be successfully treated and usually recover within a few hours.

You can find reports of all side effects in the patient information leaflet for the vaccine. For more information on side effects, go to:

• Boostrix-IPV
• REPEVAX

If your child’s symptoms get worse or if you are concerned, contact NHS 111 Wales by calling 111 or your GP surgery. Calls to NHS 111 Wales are free from landlines and mobile phones.

You should report suspected side effects of vaccines and medicines online at Yellow Card, by downloading the Yellow Card app, or by calling 0800 731 6789 (Monday to Friday, 9am to 5pm).

A dose of the correct-strength liquid paracetamol may help reduce your child’s fever. Read the instructions on the bottle very carefully and give the correct dose for your child’s age. You may need to give another dose four to six hours later. Liquid paracetamol is not recommended before vaccination to prevent a fever.

Remember – children under 16 should not take medicines that contain aspirin. 

If you are worried about your child after the vaccination you should speak to your health visitor, GP or practice nurse. You can also contact NHS Wales by calling 111. Calls to NHS 111 Wales are free from landlines and mobile phones.

The 4-in-1 vaccination is one of the most effective ways to prevent severe illness from diphtheria, tetanus, whooping cough and polio. No vaccine is 100% effective, so it is still important to know the signs and symptoms of these diseases, even if you or your child are vaccinated.

For more information about diphtheria, tetanus, whooping cough and polio visit the NHS 111 Wales website:

• Diphtheria
• Tetanus
• Whooping cough
• Polio