You can protect your children from 5 diseases by giving them 1 easy vaccine. The 5-in-1 vaccine protects against:

1. Diphtheria
2. Tetanus
3. Pertussis (whooping cough)
4. Polio
5. Hib disease

In Canada, most children get the 5-in-1 vaccine when they are 2, 4, 6, and 18 months old.

Your child will get a booster of the 4-in-1 vaccine at 4 to 6 years of age. The 4-in-1 shot vaccine against:

1. Diphtheria
2. Tetanus
3. Pertussis
4. Polio

A booster of Hib vaccine is not needed if your child already received all 4 doses of the 5 in 1 vaccine.

For complete protection, your child needs to receive all vaccines and at the right time. Ask your doctor or nurse for a record book to help you keep track of your child’s immunizations.

What is diphtheria?

• It’s an illness caused by bacteria (germs) that infect the nose, throat or skin.
• It causes serious problems with breathing. It can also attack the heart, nerves and kidneys.
• About 1 out of every 10 people who get diphtheria will die from it. Babies who get it are even more likely to die.

What is tetanus?

• Also called lockjaw, it is caused by a toxin (poison) that can be found in dirt and dust.
• When tetanus gets into an open cut, the poison can spread to the spinal cord through the bloodstream by traveling up nerves from the muscle. Muscles may lock in one place or go into spasms (get very tight). This is very painful.
• The first muscles affected are the ones in the jaw. A person with tetanus may not be able to swallow or open his or her mouth. This is why it is called lockjaw.
• If tetanus gets to the muscles that help a person breathe, it can cause death very quickly.
• Children who survive tetanus may have long-lasting problems with speech, memory and thinking. Even if a child has it once, he can still get it again.
• The tetanus vaccine protects both adults and children. Ask your doctor how you can get a tetanus vaccine so you can protect yourself, too.

What is pertussis?

• Also called whooping cough, pertussis is caused by germs that get into the throat and lungs.
• Children may cough so long and so hard that they can’t breathe.
• Babies with whooping cough may have fits (seizures) and go into a coma. About 1 in 400 infants with pertussis dies because of pneumonia or brain damage.
• Older children who get whooping cough will have 1 to 2 weeks of severe coughing spells. In total, the disease can last from 6 to 12 weeks.

What is polio?

• It’s an infection caused by a virus called poliovirus.
• Symptoms can include fever, sore throat, headache, muscle aches and pains, drowsiness, loss of appetite, nausea, vomiting, stomach pain and constipation. It can also make children very tired and cause stiffness in the neck and back.
• Some people with polio don’t feel sick at all.
• About 1 in every 100 people who get the virus will get the severe form of the disease, which causes paralysis (not able to move arms or legs) for the rest of their lives. Some people die from polio.

What is Hib disease?

• Hib stands for Haemophilus Influenzae type b. Despite its name, it has nothing to do with the flu.
• Hib is a bacterium (germ) that starts in the nose or throat and can infect almost any other part of the body, such as the lungs, heart, joints, bones and skin.
• It can cause a very serious disease called meningitis when it infects the fluid and covering of the brain and spinal cord.
• Without treatment, all children with Hib meningitis die.
• Even with treatment, about 1 in 20 children with Hib meningitis will die.
• About 1 in 3 children who live will have brain damage.

How safe is the 5-in-1 shot?

• It is very safe.
• Children who had a bad allergic reaction to a previous dose of the vaccine should not get it again.

Are there any side effects to the vaccine?

• With any vaccine, there may be some redness, swelling or pain at the place where the needle went into the arm or leg.

How can I minimize the pain?
Needles can hurt. To lessen the pain you can:

• Apply a topical anaesthetic (a cream that causes temporary numbness) an hour before getting the needle. You may have to ask your doctor where he will give the shot (for example, in the arm or leg). Your pharmacist can help you find the cream.
• Give your baby sugar water (with a teaspoon or pacifier) just before the shot, or nurse your baby while he gets the needle.
• Use distractions (blow bubbles, read a book), suggest deep breathing, remain calm and physically comfort your child (cuddle, hold hands) during the needle.
• If your child is crying or fussy after getting the shot, you can give her acetaminophen.

For complete information on vaccinations in Canada, read Your Child's Best Shot: A Parent's Guide to Vaccination.

Reviewed by the CPS Infectious Diseases and Immunization Committee

Updated: April 2008