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Generic Name: diphtheria, haemophilus influenzae, pertussis, and tetanus vaccine (dif THEER ee a, hem OFF il us in floo ENZ uh per TUS is , and TET a nus)
Brand Names: ActHIB with DPT, Trihibit

What is diphtheria, haemophilus influenzae, pertussis, and tetanus vaccine?

Diphtheria, haemophilus influenzae, pertussis, and tetanus are serious diseases caused by bacteria.

Diphtheria causes a thick coating in the nose, throat, and airway. It can lead to breathing problems, paralysis, heart failure, or death.

Haemophilus influenzae can cause minor flu symptoms or it can cause more serious symptoms such as swelling around the throat, making it hard to swallow or breathe. Haemophilus influenzae can also cause swelling of the membranes around the brain and spinal cord (meningitis).

Pertussis (whooping cough) causes coughing so severe that it interferes with eating, drinking, or breathing. These spells can last for weeks and can lead to pneumonia, seizures (convulsions), brain damage, and death.

Tetanus (lockjaw) causes painful tightening of the muscles, usually all over the body. It can lead to "locking" of the jaw so the victim cannot open the mouth or swallow. Tetanus leads to death in about 1 out of 10 cases.

Diphtheria, haemophilus influenzae, and pertussis are spread from person to person. Tetanus enters the body through a cut or wound.

The diphtheria, haemophilus influenzae, pertussis, and tetanus vaccine is used to help prevent these diseases in people who are ages 2 months to 5 years old.

This vaccine works by exposing your child to a small dose of the bacteria or a protein from the bacteria, which causes the body to develop immunity to the disease. This vaccine will not treat an active infection that has already developed in the body.

Like any vaccine, the diphtheria, haemophilus influenzae, pertussis, and tetanus vaccine may not provide protection from disease in every person.

What is the most important information I should know about this vaccine?

The diphtheria, haemophilus influenzae, pertussis, and tetanus vaccine is given in a series of shots. The first shot is usually given when the child is 2 months old. The booster shots are then given at 4 months, 6 months, and 12 to 15 months of age. Your child's individual booster schedule may be different from these guidelines. Follow your doctor's instructions or the schedule recommended by the health department of the state you live in.

Be sure your child receives all recommended doses of this vaccine. If your child does not receive the full series of vaccines, he or she may not be fully protected against the disease.

Your child can still receive a vaccine if he or she has a cold or fever. In the case of a more severe illness with a fever or any type of infection, wait until the child gets better before receiving this vaccine.

Keep track of any and all side effects your child has after receiving this vaccine. When the child receives a booster dose, you will need to tell the doctor if the previous shots caused any side effects.

Becoming infected with diphtheria, haemophilus influenzae, pertussis, or tetanus is much more dangerous to your child's health than receiving the vaccine to protect against these diseases. Like any medicine, this vaccine can cause side effects, but the risk of serious side effects is extremely low.

What should I discuss with my healthcare provider before receiving this vaccine?

• severe or uncontrolled epilepsy or other seizure disorder; or

• if the child has received cancer chemotherapy or radiation treatment in the past 3 months.

Your child may not be able to receive this vaccine if he or she has ever received a similar vaccine that caused any of the following:

• a very high fever (over 104 degrees);

• a neurologic disorder or disease affecting the brain;

• excessive crying for 3 hours or longer;

• fainting or going into shock;

• seizure (convulsions); or

• Guillain-Barré syndrome (within 6 weeks after receiving a vaccine containing tetanus).

Before receiving this vaccine, tell the doctor if your child has:

• a bleeding or blood clotting disorder such as hemophilia or easy bruising;

• a history of seizures;

• a neurologic disorder or disease affecting the brain (or if this was a reaction to a previous vaccine);

• an allergy to latex rubber;

• a weak immune system caused by disease, bone marrow transplant, or by using certain medicines or receiving cancer treatments; or

• if the child is taking a blood thinner such as warfarin (Coumadin).

Your child can still receive a vaccine if he or she has a cold or fever. In the case of a more severe illness with a fever or any type of infection, wait until the child gets better before receiving this vaccine.

How is this vaccine given?

This vaccine is given as an injection into a muscle. Your child will receive this injection in a doctor's office or other clinic setting.

The diphtheria, haemophilus influenzae, pertussis, and tetanus vaccine is given in a series of shots. The first shot is usually given when the child is 2 months old. The booster shots are then given at 4 months, 6 months, and 12 to 15 months of age. Your child's individual booster schedule may be different from these guidelines. Follow your doctor's instructions or the schedule recommended by the health department of the state you live in.

Your doctor may recommend treating fever and pain with an aspirin-free pain reliever such as acetaminophen (Tylenol) or ibuprofen (Motrin, Advil, and others) when the shot is given and for the next 24 hours. Follow the label directions or your doctor's instructions about how much of this medicine to give your child.

What happens if I miss a dose?

Contact your doctor if you will miss a booster dose or if you get behind schedule. The next dose should be given as soon as possible. There is no need to start over.

Be sure your child receives all recommended doses of this vaccine. If your child does not receive the full series of vaccines, he or she may not be fully protected against the disease.

What happens if I overdose?

An overdose of this vaccine is unlikely to occur.

What should I avoid before or after receiving this vaccine?

There are no restrictions on food, beverages, or activity before or after receiving this vaccine unless your child's doctor has told you otherwise.

This vaccine side effects

Becoming infected with diphtheria, haemophilus influenzae, pertussis, or tetanus is much more dangerous to your child's health than receiving the vaccine to protect against these diseases. Like any medicine, this vaccine can cause side effects, but the risk of serious side effects is extremely low.

Call your doctor at once if the child has any of these serious side effects:

• extreme drowsiness, fainting;

• fussiness, irritability, crying for an hour or longer;

• seizure (black-out or convulsions); or

• high fever.

Less serious side effects include:

• redness, pain, tenderness, or swelling where the shot was given;

• low fever;

• mild fussiness or crying;

• headache or tiredness;

• joint pain, body aches;

• loss of appetite; or

• mild nausea, diarrhea, or vomiting.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome to the child.

What other drugs will affect diphtheria, haemophilus influenzae, pertussis, and tetanus vaccine?

Also tell the doctor if your child has received drugs or treatments in the past 2 weeks that can weaken the immune system, including:

• an oral, nasal, inhaled, or injectable steroid medicine;

• medications to treat psoriasis, rheumatoid arthritis, or other autoimmune disorders, such as azathioprine (Imuran), efalizumab (Raptiva), etanercept (Enbrel), leflunomide (Arava), and others; or

• medicines to treat or prevent organ transplant rejection, such as basiliximab (Simulect), cyclosporine (Sandimmune, Neoral, Gengraf), muromonab-CD3 (Orthoclone), mycophenolate mofetil (CellCept), sirolimus (Rapamune), or tacrolimus (Prograf).

If your child is using any of these drugs, he or she may not be able to receive the vaccine.

There may be other drugs that can affect this vaccine. Tell your doctor about all the prescription and over-the-counter medications your child has received. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your child's doctor.

Where can I get more information?

• Your doctor or pharmacist may have information about this vaccine written for health professionals that you may read. You may also find additional information from your local health department or the Centers for Disease Control and Prevention.

• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.