5-in-1 or 6-in-1 vaccine
You can protect your children from 5 diseases by giving them 1 easy vaccine. The 5-in-1 vaccine protects against:
- Pertussis (whooping cough)
- Hib disease
In some provinces hepatitis B vaccine is also included, making it a 6-in-1 vaccine.
In Canada, most children get the 5-in-1 vaccine when they are 2, 4, 6, and 18 months old. The 6-in-1 vaccine may replace 5-in-1 at 2, 4 and 6 or at 2, 4 and 18 months. Only three doses of hepatitis B vaccine are needed.
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 protects against:
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 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?
- Diphtheria is an illness caused by bacteria (germs). It produces a poison (toxin) that kills cells in the lining of the throat and causes serious breathing problems. It can also attack the heart, nerves and kidneys.
- About 1 person in 10 with diphtheria will die from the illness. Babies who get it are even more likely to die.
- Diphtheria must be treated with an anti-toxin (a serum that fights the poison). Antibiotics have no effect on the disease but are used to prevent the spread of the bacteria to others.
- People who get diphtheria do not always become immune. Everyone needs to be vaccinated.
What is tetanus?
- Also called lockjaw, tetanus is caused by germs (bacteria) that are found in dirt and dust as spores (seed-like cells). These bacteria live in the intestines (bowels) of people and animals and can be found in the stools.
- Tetanus is not contagious: it does not spread from person to person.
- If the tetanus germ gets into an open cut, like a puncture, bite or serious burn, poison (toxin) from the germ can spread to your nerves and then to your muscles. Muscles may lock in one place or go into spasm (get very tight). This is very painful.
- Jaw muscles are often the first affected. You may not be able to swallow or open your mouth. If the poison gets to the muscles that help you breathe, you can die quickly.
- The main treatment for tetanus is anti-toxin (a serum that fights the poison).
- Antibiotics are also given to kill the germs. Other drugs are used to control the muscle spasms. A machine may be needed to help breathing.
- Between 1 and 8 people in 10 with tetanus will die.
- People who survive tetanus may have long-lasting problems with speech, memory and thinking.
- People who survive can get tetanus again. Infection does not give immunity. Everyone needs the vaccine.
What is pertussis?
- Also called whooping cough, pertussis is caused by germs that get into the throat and lungs and makes it difficult to clear mucous from the airways.
- Children may cough so long and so hard that they can’t breathe. Young infants may not be able to cough forcefully and may stop breathing.
- Babies with whooping cough may have fits (seizures) and in serious cases, go into a coma.
- About 1 in 400 infants with pertussis dies because of pneumonia or brain damage.
- Older children, adolescents and adults who get whooping cough will cough for more than 3 weeks, and cough may last up to 12 weeks.
- Coughing disturbs sleep and may be severe enough to cause a rib fracture or a hernia or loss of control of urine.
What is polio?
- Polio is an infection caused by a virus called poliovirus.
- Some people with polio don’t feel sick at all.
- Symptoms can include fever, sore throat, headache, muscle aches and pains, drowsiness, loss of appetite, nausea, vomiting, stomach pain and constipation. It can also cause meningitis (headache and stiffness in the neck and back).
- About 1 in every 100 people who get the virus will get a severe form of the disease, which causes paralysis (not able to move arms or legs). If the chest muscles are paralyzed, the person cannot breathe and will need a machine to breathe for them.
- Some people die from polio. Most of those who survive are paralyzed for the rest of their lives.
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 bacteria (germ) that starts in the nose or throat and can infect almost any other part of the body, such as the brain, 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 permanent brain damage.
What is hepatitis B infection?
Hepatitis B is a disease caused by a virus that infects the liver. For more information, please visit the hepatitis B page.
How safe are the 5-in-1 and 6-in-1 shots?
- They are very safe.
- Children who have had a serious allergic reaction to a previous dose of the vaccine (swelling of the face or lips, difficulty breathing or if your blood pressure drops) should not get it again unless seen by a specialist and vaccinated in a special clinic that can control severe reactions.
Are there any side effects to the vaccine?
- With any vaccine, there may be some redness, swelling, tenderness or pain where the needle went into the arm or leg.
- Fever is common.
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 or nurse where the shot will be given (for example, in the arm or leg). Your pharmacist can help you find the cream.
- Nurse your baby while he gets the needle, or give your baby sugar water (with a teaspoon or pacifier) just before the shot.
- For older children, use distractions (blow bubbles, read a book), suggest deep breathing, remain calm and physically comfort your child (cuddle, hold hands) during the needle.
Parents and caregivers should NOT give their child ibuprofen or acetaminophen before or shortly after vaccination since it could have an impact on how well the vaccine works. Wait at least 6 hours post-vaccination for pain or fever relief.
More information from the CPS:
Reviewed by the following CPS committees:
- Infectious Diseases and Immunization Committee
Last Updated: July 2015