Hexaxim (DTaP + IPV + Hepatitis B + HiB) Vaccine

DTaP-IPV-Hepatitis B-HiB Vaccine

Hexaxim painless vaccine

Hexaxim vaccine as its name implies is a hexavalent combination vaccine. It protects against diseases diphtheria, pertussis, tetanus, hepatitis B, IPV and Haemophilus influenzae type b

It contains purified pertussis toxin and cell components so it is a relatively painless vaccine. 

As indicated in above table it contains diphtheria toxoid 30 LF, tetanus toxoid 10 Lf, pertussis toxoid 25 mcg and filamentous haemaggutinin 25 mcg, Poliovirus inactivated type 1 40 DU, poliovirus inactivated type 2 8 DU, poliovirus inactivated type 3 32 DU, Haemophilus influenzae type b polysaccharide 12 mcg in conjugated form to tetanus toxoid, other inactive ingredients include aluminium hydroxide 0.6 mg.

Buffers include disodium hydrogen phosphate, potassium hydrogen phosphate, essential amino acids, trometamol, saccharose. 

It contains water to make a total volume of 0.5 ml. Effectively it is DTaP-IPV-HiB-Hepatitis B vaccine.

ComponentsQuantity per 0.5 ml
Active ingredients
Diphtheria Toxoid30 Lf
Tetanus toxoid10 Lf
Bordetella pertussis antigens Pertussis toxoid Filamentous haemagglutinin  25 mcg 25 mcg
Poliovirus inactivated Type 1 (Mahoney) Type 2 (MEF-1) Type 3 (Saukett)  40 DU 8 DU 32 DU
Hepatitis B surface antigens10 mcg
Haemophilus influenzae type b polysaccharide (PRP) Conjugated to tetanus toxoid protein (PRP-T)12 mcg   22-36 mcg
Inactive ingredients:
Aluminium hydroxide (hydrated)0.6 mg
Buffers Disodium hydrogen phosphate Potassium hydrogen phosphate Essential amino acids Trometamol Saccharose  1.528 mg 1.552 mg 1.115 mg 0.1515 mg 10.625 mg
Water for injectionUp to 0.5 ml
Contents of Hexaxim vaccine

How is this Hexaxim available?

Hexaxim vaccine is available as an injection liquid form. It is a single dose packet. It comes in a pre-filled syringe. Generally a needle for intramuscular injection is included in the packet. The liquid for injection looks hazy and colourless normally.

How is Hexaxim vaccine stored?

Hexaxim vaccine is stored at 2-8 degree Celsius. The temperature range should be strictly maintained with the help of a cold chain at all stages of transport and storage. 

The vaccine should not be accidentally frozen. If accidentally frozen, the vaccine should be discarded and not used.

How is Hexaxim vaccine given?

Hexaxim vaccine is given by injection. The dose of this vaccine is  0.5 ml liquid. The injection is given with a pre-filled syringe attached to the needle. 

It is generally given on the anterolateral aspect of the thigh. It should be given with all safety injection precaution protocols. 

The disposable are discarded as per bio-medical waste management protocols.

At what age is the Hexaxim vaccine given?

Hexaxim vaccine is given at age 6-10-14 weeks followed by a booster of DTaP-HiB-IPV at 18 months. 

If penta valent booster DTaP-HiB-IPV (Pentaxim) is not available at 18 months then Hexaxim can be safely used for the booster too.

Otherwise booster at 18 months is done with pentaxim vaccine and at 5 years Tetraxim can be used.

Safety with other vaccine:

Hexaxim vaccine can be safely given with BCG, MMR, Measles, yellow fever, pneumococcal vaccine, rotavirus vaccine and most other vaccines.

This vaccine should not be mixed with other medicines or vaccines while injecting.

Separate syringe should be used to inject and separate location of the body preferably a separate limb.

How does the Hexaxim vaccine work?

Hexaxim vaccine when given as indicated doses and schedule, it protects from diphtheria, tetanus, pertussis, polio, hepatitis B and Haemophilus influenzae type b. 

It contains inactivated killed components of all these bacteria or viruses. It is an active method of immunization

When injected to the child the immune system of the child recognizes the antigens as foreign antigens and immune response is induced against the antigens. It contains conjugated Haemophilus polysaccharide antigens. 

Conjugated forms help to boost the immune response and also the long term immunity is induced. The pertussis components help to enhance the immune response against diphtheria and tetanus. 

Additionally aluminium salt in it helps the immune system to recognize the antigens more efficiently. This vaccine is safe below age 7 years. 

This vaccine contains all 3 poliovirus strains in inactivated form which when injected are very efficient in inducing the immunity.

What are the side effects of Hexaxim vaccine?

Hexaxim vaccine contains acellular pertussis components in purified form so the side effects are relatively less with the Hexaxim vaccine when compared to DPT whole cell killed pertussis containing vaccine.

Very common side effects are:

  • Loss of appetite may occur after vaccination but usually improves on its own.
  • Crying may last for a few hours and usually subsides on its on.
  • Sleepiness may occur after vaccination in some children may subside with time on its own.
  • Vomiting may occur after vaccination. Mostly subsided by its own. It can be managed with increasing the frequency of the feeding and if needed oral medication like ondansetron.
  • Pain, redness and swelling at injection sites can occur for 1-3 days, usually less severe than whole cell pertussis containing vaccines. It can be easily managed at home with oral medicine like paracetamol and local cold fomentation.
  • Irritability.
  • Fever: May last for 1-3 days. Usually mild to moderate grade. It can be easily managed at home with oral medication like paracetamol.

Common side effects are:

1. Abnormal crying.

2. Diarrhea can be easily managed with increasing frequency of feeding and oral rehydration solution. It usually subsides by its own.

3. Injection site hardness (induration).

Rare side effects are:

1. Allergic/anaphylactic reaction.

2. Lump at injection site.

3. High fever.

Though side effects are there they are usually mild and manageable at home. Fever and pain can be easily managed by oral medicine like paracetamol and local cold fomentation at injection sites. 

Side effects are much lesser when compared to whole cell pertussis vaccines and the actual diseases which the vaccine prevents.

Like all other vaccines this vaccine can very rarely cause anaphylaxis reaction which can be life threatening if not managed swiftly. 

It is suggested to give all the vaccines at the center which is anaphylaxis management ready. Necessary drugs and equipment and a skilled person is available to manage the reaction.

To whom this vaccine should not be given?

This vaccine should not be given to those who are allergic to any of its components.

This vaccine should not be given to those who had got anaphylactic or severe allergic reaction to the previous dose of the vaccine.

This vaccine is safe for use in ages below 6 years.

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