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Diphtheria / Tetanus Toxoids / Acellular Pertussis, Adsorbed / Inactivated Poliovirus Combination Vaccine ( DTAP/IPV )

Pronunciation: dif-THEER-ee-a TET-ah-nus ay-SELL-yoo-ler per-TUSS-uss poe-lee-oh-VYE-russ
Class: Toxoid, Vaccine combination

Trade Names

- Injection, suspension 0.5 mL


Diphtheria and tetanus toxoids induce antibodies against toxins made by Corynebacterium diphtheriae and Clostridium tetani , respectively; pertussis vaccine protects against Bordetella pertussis ; poliovirus virus induces protective antipoliovirus antibodies, reducing pharyngeal excretion of poliovirus types 1, 2, and 3.

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Indications and Usage

A single dose is indicated for active immunization against diphtheria, tetanus, pertussis, and poliomyelitis; as the fifth dose in diphtheria, tetanus, and acellular pertussis (DTaP) vaccine series; and as the fourth dose in the inactivated poliovirus vaccine (IPV) series in children 4 through 6 yr of age whose previous purified toxoid aluminum phosphate (PTaP) vaccine doses have been with Infanrix and/or Pediarix for the first 3 doses and Infanrix for the fourth dose.


Severe allergic reaction (eg, anaphylaxis) after a previous dose of any diphtheria toxoid, tetanus toxoid, pertussis- or poliovirus-containing vaccine, or to any component of the product, including neomycin and polymyxins B; encephalopathy (eg, coma, decreased consciousness, prolonged seizures) within 7 days of administration of a previous dose of a pertussis-containing vaccine that is not attributable to another cause; progressive neurologic disorder, including infantile spasms, uncontrolled epilepsy, or progressive encephalopathy.

Dosage and Administration

Children 4 to 6 yr of age

IM 0.5 mL.

General Advice

  • Shake vigorously to obtain a homogeneous, turbid, white suspension. Do not use if resuspension does not occur.
  • Preferred administration site is the deltoid muscle of the upper arm.


Store refrigerated between 36° and 46°F. Do not freeze.

Drug Interactions

Immunosuppressive therapies (eg, alkylating agents, antimetabolites, corticosteroids, cytotoxic drugs, irradiation)

Optimal response to active immunization may be reduced.

Other vaccines

Do not administer other vaccines in the same syringe.

Laboratory Test Interactions

None well documented.

Adverse Reactions


Drowsiness (19%); cerebrovascular accident, convulsions (postmarketing).


Pruritus (postmarketing).


Constipation, gastroenteritis.


Lymphadenopathy, thrombocytopenia (postmarketing).


Pain (57%); redness (37%); increased arm circumference (36%); swelling (26%); injection-site vesicles (postmarketing).


Dehydration, hypernatremia.


Apnea (postmarketing).


Fever, loss of appetite (16%); cellulitis; foreign body trauma; allergic reactions, including anaphylactoid reactions, anaphylaxis, angioedema, and urticaria, collapse or shock-like state (hypotonic-hyporesponsive episode) (postmarketing).



Prior to administration, review the patient's immunization history for possible vaccine sensitivity and previous vaccination-related adverse reactions.


Category C .


Safety and efficacy not established in children younger than 4 yr of age or children 7 to 16 yr of age.

Special Risk Patients

If any of the following events occur in temporal relation with receipt of pertussis-containing vaccine, administration of any pertussis-containing vaccine, including Kinrix , should be based on careful consideration of potential benefits and possible risks: temperature of 105°F or more within 48 h, not attributable to another cause; collapse or shock-like state (hypotonic-hyporesponsive episode within 48 h); persistent, inconsolable crying lasting 3 h or more within 48 h; seizure with or without fever within 3 days.

Allergic reactions

Epinephrine hydrochloride solution (1:1,000) and other appropriate agents and equipment must be available for immediate use in case of occurrence of an anaphylactic or acute hypersensitivity reaction.

Guillain-Barré syndrome

If Guillain-Barré syndrome occurred within 6 wk of receiving a prior vaccine containing tetanus toxoid, the decision to give Kinrix vaccine or any vaccine containing tetanus toxoid should be based on careful consideration of potential benefits and possible risks.

Latex sensitivity

The tip cap and rubber plunger of the needleless prefilled syringes contain dry natural latex rubber, which may cause allergic reactions in latex-sensitive individuals.


For infants and children at risk of seizures, an appropriate antipyretic may be administered at the time of vaccination and for the following 24 h to reduce possible postvaccination fever.

Patient Information

  • Advise parent or guardian to notify health care provider if bothersome side effects occur or last more than 24 h.
  • Provide and review vaccine information sheet prior to immunization.

Copyright © 2009 Wolters Kluwer Health.