DTaP/IPV/Hib/HepB (6 in 1) vaccine - About the 6 in 1 vaccine

If someone is ill and getting worse, do not wait for a rash as symptoms can appear in any order and some may not appear at all, so get medical help urgently. If you can’t get in touch with your doctor, or are still worried after getting advice, trust your instincts and go to the emergency department of your nearest hospital.

Someone with a fever and a rash that does not fade under pressure needs urgent medical attention. You can use the glass test to check whether a rash fades under pressure.

Meningitis glass test 

• Press the side of a clear glass firmly against the skin.
• Spots or a rash (or both) may fade at first.
• Keep checking.
• Fever with spots or a rash (or both) that do not fade under pressure is a medical emergency.
• If your child is ill and getting worse, get medical help immediately.
• On dark skin, the spots or rash can be more difficult to see.

For more information, see Meningitis Now or call the Meningitis Now helpline on 0808 80 10 388.

Baby immunisations 

It is important to offer protection to babies as soon as possible, as they can catch these serious diseases from birth.

The 6-in-1 (DTaP/IPV/Hib/HepB) vaccine is given to babies at eight weeks, 12 weeks and 16 weeks of age. From January 2026 babies will also get a 6-in-1 vaccination at 18 months.

From 1 January 2026 your child will be offered a 6-in-1 vaccination at 18 months.

Having an extra 6-in-1 vaccination is safe and effective.

For information about why your child has been invited for a vaccination at 18 months, see: Changes to the childhood immunisation schedule

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 baby needs a tetanus vaccine.

If you have any questions about the 6-in-1 vaccine, or you are not sure about when it should be given, contact your GP surgery for advice.

You can find more information about schedule changes to the routine childhood immunisation programmes on our website.

The 6-in-1 vaccine currently available in the UK is known under the brand names Infanrix and Vaxelis.

If you would like to learn more about this vaccine, you can read the patient leaflet at:

• Infanrix hexa
• Vaxelis

If your baby or child has missed an appointment for the 6-in-1 vaccination, speak to your GP or practice nurse for advice.

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

• 4-in-1 vaccine
• 3-in-1 vaccine

The practice nurse or GP will explain about the vaccinations and answer your questions. With babies, the vaccine is given by injection in the thigh. 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. 

Very few children cannot have the 6-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.

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

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

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

The most common side effects include: 

• a sore leg or arm where the injection was given
• a small lump where the needle was put in (this is normal and may last some weeks and does not need any treatment)
• a raised temperature (fever) over 38°C
• feeling unsettled, and
• loss of appetite.

If your child has a raised temperature and seems unwell, keep them cool by:

• making sure they don’t have too many layers of clothes or blankets on, and
• giving them plenty of cool drinks.

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.

These symptoms may be a sign of a serious allergic reaction and usually happen within 15 minutes of being vaccinated. Call 999 straight away if your child has had the vaccine and has any of these symptoms.

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

• Infanrix hexa
• Vaxelis

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 6-in-1 vaccination is one of the most effective ways to prevent severe illness from diphtheria, tetanus, whooping cough, polio, Hib and hepatitis B. 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
• Hib (Haemophilus influenzae type b)
• Hepatitis B