OBJECTIVE

To evaluate the clinical utility of diphtheria and tetanus toxoids and acellular pertussis adsorbed and inactivated poliovirus vaccine ([DTaP-IPV]; Kinrix) and diphtheria and tetanus toxoids and acellular pertussis adsorbed,inactivated poliovirus and Haemophilus b conjugate (tetanus toxoid conjugate)vaccine ([DTaP-IPV/Hib]; Pentacel) in the schedule for pediatric immunizations.

DATA SOURCES

PubMed was searched (1966-April 2009) using the key words Kinrix and Pentacel. Subject headings included vaccines, combined; diphtheria-tetanus-pertussis vaccine; diphtheria-tetanus-acellular pertussis vaccines; poliovirus vaccine, inactivated; and Haemophilus influenzae type b polysaccharide vaccine tetanus toxin conjugate. The search was limited to English-language publications involving humans. Product labeling was obtained from GlaxoSmithKline and Sanofi Pasteur. The Centers for Disease Control and Prevention (CDC) Web site was searched for relevant recommendations published June 2008-October 2009.

STUDY SELECTION AND DATA EXTRACTION

Phase 2 and 3 clinical trials evaluating immunogenicity and safety of DTaP-IPV and DTaP-IPV/Hib were reviewed. Published trials were supplemented with abstracts, review articles, manufacturer product labeling, and CDC recommendations.

DATA SYNTHESIS

DTaP-IPV is immunogenic compared to its component vaccines,with no effect of concomitantly administered measles, mumps, and rubella vaccine.Although injection site pain has occurred more with the combination vaccine, its use would reduce by 1 the number of injections given when a child is 4-6 years old.DTaP-IPV/Hib is immunogenic and safe compared to separate vaccines.Immunogenicity to 7-valent pneumococcal conjugate vaccine and hepatitis B(HepB) vaccine is not affected by concomitant administration. DTaP-IPV/Hib decreases injections by up to 7 when given at 2, 4, 6, and 15-18 months of age. It fits into the schedule more easily than DTaP-HepB-IPV (Pediarix), the other DTaP containing combination vaccine indicated for the primary infant series.

CONCLUSIONS

DTaP-IPV and DTaP-IPV/Hib combination vaccines are immunogenic and safe when given to infants and children. They reduce the number of required injections. Combination vaccines are encouraged to promote timely vaccination and complete immunization schedules.