DTaP-IPV-Hib — diphtheria, tetanus, pertussis, polio, and Hib combination vaccine
Also called the "5-in-1" because it combines protection against five diseases in a single injection.
The 5-in-1 vaccine protects against five separate diseases. Here's what each one is and why it matters.
| Disease | What parents might notice | How it spreads | Why it can be serious | How vaccination helps |
|---|---|---|---|---|
| Diphtheria | Sore throat, fever, chills, and a thick coating at the back of the throat that can make breathing difficult. | Coughing, sneezing, and close contact. | Can cause breathing problems, heart failure, paralysis, and death. | The vaccine trains the immune system to neutralize the toxin produced by the bacteria. |
| Tetanus | Muscle stiffness and spasms, often starting in the jaw ("lockjaw"). | Bacteria entering the body through a cut or wound — it does not spread from person to person. | Severe muscle spasms can affect breathing and be life-threatening. | The vaccine helps the body neutralize the toxin produced by the bacteria before it causes harm. |
| Pertussis (whooping cough) | Severe coughing fits, sometimes followed by a "whooping" sound when breathing in. | Coughing and sneezing. | Especially dangerous for infants, who can have trouble breathing, pneumonia, or, rarely, more serious complications. | The vaccine helps reduce the chance of infection and severity of illness if infection occurs. |
| Polio | Often no symptoms at all; in some cases, flu-like symptoms or, rarely, paralysis. | Contact with an infected person's stool, or sometimes respiratory droplets. | Can cause permanent paralysis or be life-threatening in a small number of cases. | The vaccine helps the immune system recognize and stop the virus before it can cause paralysis. |
| Hib (Haemophilus influenzae type b) | Often no early symptoms; can lead to serious infections such as meningitis or epiglottitis (severe throat swelling). | Coughing, sneezing, and close contact. | Before vaccination programs, Hib was a leading cause of bacterial meningitis in young children. | The vaccine helps the immune system recognize the bacteria's outer coating and respond quickly if exposed. |
Why so early? Babies are born with some temporary protection from their birthing parent, but this fades over the first few months of life — right around the time some of these diseases are most dangerous. Starting the series at 2 months helps build a baby's own protection during this vulnerable window.
Why four doses? Young immune systems typically need more than one exposure to build strong, lasting protection. Each dose builds on the last — the 2, 4, and 6-month doses form the primary series, and the 18-month dose acts as a booster to reinforce that protection as the child grows.
What if a dose is late? If a dose is delayed, it does not mean the series needs to restart. In general, the next dose can be given at the next available opportunity, maintaining the recommended minimum spacing between doses. A healthcare provider or your local public health unit can confirm the right timing based on your child's specific history. See the Catch-Up & Missing Records page for more detail.
Can it be given with other vaccines? Yes. The 5-in-1 vaccine is routinely given at the same visit as the pneumococcal conjugate and rotavirus vaccines (at 2 and 4 months), and alongside other scheduled vaccines at 6 and 18 months. Vaccines given at the same visit are typically administered at different injection sites.
In practice, this means that when a child receives the 5-in-1 vaccine, they are receiving protection against both the ISPA-required diseases and Hib together in one injection — there is no need to separate them. The distinction mainly matters for understanding why this vaccine is tracked for school purposes.
Reporting: As with all vaccines, parents and caregivers are generally responsible for reporting their child's immunizations to their local public health unit. Healthcare providers do not always do this automatically. After each dose, make sure your provider updates your child's immunization record (the "yellow card"), and report the update to your local public health unit — for example, through Immunization Connect Ontario (ICON) if your area uses it.
Exemptions: If your child cannot receive this vaccine for medical reasons, or you are seeking a non-medical exemption based on conscience or religious belief, see the School Requirements hub for the exemption process.
The information below reflects the product commonly used in Ontario's publicly funded program, Pediacel® (Sanofi Pasteur), based on its Health Canada product monograph. Other Health Canada-authorized products with similar ingredients may be used depending on supply.
| Ingredient / Component | Category | Why it's there | Plain-English explanation |
|---|---|---|---|
| Diphtheria, tetanus toxoids; pertussis, polio, and Hib antigens | Active ingredients | These are the parts of the vaccine that train the immune system to recognize each disease. | Toxoids are inactivated toxins — they can no longer cause illness but still teach the immune system to respond. The pertussis, polio, and Hib components are similarly treated or purified so they cannot cause the diseases themselves. |
| Aluminum phosphate | Adjuvant | Helps the immune system respond more strongly to the vaccine. | Adjuvants are commonly used in vaccines to improve the immune response, often allowing for a smaller or fewer doses of the active ingredient. Aluminum-containing adjuvants have been used in vaccines for decades and are present in only small amounts per dose. |
| 2-phenoxyethanol | Preservative | Helps prevent contamination of the vaccine. | A preservative used in small amounts in some injectable products, including some cosmetics and other medical products. |
| Polysorbate 80 | Stabilizer / emulsifier | Helps keep the vaccine's ingredients evenly mixed and stable. | A common ingredient in many foods, cosmetics, and medications that helps liquids and other substances mix together and stay stable. |
| Formaldehyde and glutaraldehyde (trace amounts) | Manufacturing process residual | Used during manufacturing to inactivate the toxins used in the vaccine; trace amounts may remain. | These substances are used to safely inactivate the diphtheria and tetanus toxins during production. The amount remaining in the final vaccine is very small — smaller than amounts the body produces naturally during normal metabolism. |
| Neomycin, polymyxin B, streptomycin (trace amounts) | Manufacturing process residual (antibiotics) | Used during manufacturing to help prevent bacterial contamination of the cell cultures used to grow vaccine components. | Trace amounts of these antibiotics may remain in the final product. This is relevant for individuals with a known severe allergy to these specific antibiotics — discuss this with a healthcare provider if it applies to your child. |
| Bovine serum albumin (trace amounts) | Manufacturing process residual | Used during the cell culture process for growing some vaccine components. | A protein derived from cow's blood, used in the manufacturing process. Trace amounts may remain in the final product. |
Expected / common side effects
Timing and duration: These reactions typically begin within a day of the vaccine and usually resolve within 1–2 days.
Home care: A cool compress can help with soreness at the injection site. Acetaminophen or ibuprofen may be used as directed to reduce discomfort or fever — check with a pharmacist or healthcare provider on appropriate dosing for your child's age and weight. Children under 19 should not be given ASA (Aspirin) or products containing salicylates. For fever or discomfort, speak with your healthcare provider or pharmacist about age-appropriate dosing. Ibuprofen is generally not used in infants under 6 months unless advised by a healthcare provider.
When to call a healthcare provider: If fever is high or persistent, if your child seems unusually unwell, or if you're simply unsure — it's always reasonable to call.
Mild side effects can happen as the immune system responds. Many children have no side effects at all, and that does not mean the vaccine didn't work.
Rare but important
What clinics do to reduce risk: Clinics ask about allergy history before vaccination and are equipped with epinephrine and trained staff in case of a severe allergic reaction.
Observation period: Many clinics recommend staying nearby for about 15 minutes after vaccination, as severe allergic reactions — though rare — typically occur shortly after the injection.
Get urgent help now if your child has:
If any of these occur, go to the nearest emergency department or call 911. Otherwise, contact a healthcare provider and let them know what happened — this information also helps with vaccine safety monitoring.
Speak with a healthcare provider before this vaccine if:
These usually do NOT require delaying this vaccine:
Where to get it
Typically given by a family doctor or nurse practitioner during routine well-child visits. Some public health units also offer clinics.
What to bring
Your child's immunization record (the "yellow card"), health card if available, and a list of any allergies or previous reactions.
If you're behind
Catching up does not mean restarting. Visit the Catch-Up & Missing Records page or ask your provider for a review.
If records are missing
Contact your local public health unit — they may have records on file, or can advise on next steps.
If vaccinated outside Ontario
Bring any available records to a healthcare provider for review — products and schedules elsewhere may differ slightly from Ontario's.
Contact public health
For record reporting, school requirements, or general questions, see the Resources page for your local public health unit's contact details.
This page is based on:
Please note: This is an independent website. It is not affiliated with, endorsed by, or operated by the Government of Ontario, the Ministry of Health, or any public health unit. The information here is for general education only and is not medical advice — always consult a licensed healthcare provider about your or your child's immunizations.