Pentavalent Vaccine: What is it? Indications, Administration, Contraindications, Adverse Effects and Frequently Asked Questions

In the first year of life, children receive vaccines that prevent diseases such as measles, rubella, diphtheria, whooping cough, and hepatitis B.

Also for pneumonia , meningitis, rotavirus and poliomyelitis, among others, most of them being injectable. In order to reduce the number of injections at the same time, combination vaccines have been developed, such as the pentavalent vaccine.

The pentavalent vaccine is composed of diphtheria and tetanus toxoids , inactivated cell suspension of Bordetella pertussis, hepatitis B surface antigen (HBs-Ag), and conjugated oligosaccharides of Haemophilus influenza type b.

Diseases that the vaccine prevents

Diphtheria, a disease caused by a toxic bacillus, often lodges in the tonsils, pharynx, larynx, nose, and occasionally other mucosa and skin.

Transmission occurs through direct contact of a sick person or carrier with susceptible people, through droplets of respiratory secretion, eliminated by coughing, sneezing or speaking. In rare cases, contamination from shared objects can occur.

Tetanus is a communicable, non-contagious disease that occurs in two ways: accidental and neonatal.

The first form generally affects people who come into contact with the tetanus bacillus when handling the soil or through injuries caused by contaminated materials, in lesions on the skin or mucosa.

Neonatal tetanus is caused by contamination during the umbilical cord section by the use of improperly sterilized or non-sterilized sharp instruments or hemostasis material, by the use of contaminated substances in the umbilical preserve such as spider web, coffee powder, smoke, manure .

Pertussis is an acute infectious disease, of respiratory transmission, universal distribution, immunopreventable and of mandatory notification. It specifically compromises the respiratory system (trachea and bronchi), and is characterized by a strong dry cough.

Transmission occurs mainly through direct contact between a sick person and a susceptible person, through the elimination of droplets of discharge from the oropharynx eliminated by coughing, speaking or sneezing.

It is rare, but transmission can also occur from objects contaminated with patient secretions.

The etiological agent of whooping cough is the bacterium Bordetella pertussis, a bacillus that man has as the main reservoir.

Hepatitis B is irritation and swelling (inflammation) of the liver due to infection with the hepatitis B virus (HBV). Hepatitis B infection can be spread through contact with the blood, semen, vaginal fluids, and other bodily fluids of someone who already has hepatitis B infection.

Most of the damage caused by hepatitis B occurs due to the way the body responds to infection.

When the body’s immune system detects the infection, it sends out special cells to fight it. However, these disease-fighting cells can cause inflammation of the liver.

Haemophilus influenzae type b bacteria is causing conditions such as pneumonia, epiglottis inflammation, otitis, bloodstream infections, and meningitis.

Meningitis is an inflammation of the meninges, the membranes that surround our brain. Pneumonia is an infection that settles in the lungs.

It can attack the region of the pulmonary alveoli, where the terminal branches of the bronchi lead and, sometimes, the space between one alveolus and another. It is a more common lung infection in babies and can even lead to hospitalization.

Acute otitis media is an ear infection in the internal part of this structure, which causes a lot of pain among the symptoms.

They are more common in children and babies, as a structure called the Eustachian tube becomes more easily congested in them. At least 30% of ear infections are caused by this bacterium.

Pentavalent Vaccine Indications

The pentavalent vaccine is indicated for the active immunization of children from two months of age against diphtheria, tetanus, pertussis, hepatitis B and diseases caused by Haemophilus influenzae type b.

With the introduction of the pentavalent vaccine, it is reinforced that in all indications for separate vaccines in special situations, the recommendations of the Standard for Reference Centers for Special Immunobiologicals should be maintained.

Can pregnant women take this vaccine?

For pregnant women, the contraindication only loses place if you are at risk of exposure to some disease.

Required doses of the vaccine

The basic vaccination consists of the application of three doses, with an interval of 60 days (minimum of 30 days), from two months of age.

The two necessary boosters will be done with the DTP vaccine (diphtheria, tetanus and pertussis). The first booster at 15 months of age and the second booster at 4 years of age.

The maximum age for the application of the DTP is 6 years 11 and 29 days. It is also emphasized that the first dose in the first 24 hours, preferably in the first 12 hours, with the hepatitis B vaccine (recombinant) will be part of this scheme for newborns.

Administration of the pentavalent vaccine

Administer 0.5 mL doses of the vaccine intramuscularly, in the vastus lateralis muscle of the thigh, in children under two years of age and in the deltoid region in children over two years of age.

It can be administered in the viral-gluteal area (more lateral), as it is free of important anatomical structures (it does not present significant blood vessels or nerves), being indicated for any age group.

The vaccine should not be administered in the dorsal gluteal region (most posterior), due to the risk of injury to the sciatic nerve) and the possibility of injecting the vaccine into fat rather than muscle. It should not be administered into a blood vessel (intravenous).


It should not be given to children:

  • With known hypersensitivity to any component of the vaccine or having manifested signs of hypersensitivity after previous administration of diphtheria, tetanus, pertussis, hepatitis B, or haemophilus influenzae B vaccines.
  • Children with neurological symptoms in activity.

Or to children who have presented after the previous dose application, any of the following events:

  • High fever (temperature greater than or equal to 39 ° C) within 48 hours after vaccination (and not due to another identifiable cause).
  • Seizures within 72 hours after the vaccine is given.
  • Circulatory collapse, with a shock-like state or with a hypotonic-hyporesponsive episode (HHE), up to 48 hours after the administration of a previous vaccine.
  • Encephalopathy in the first seven days after the administration of the previous vaccine.
  • Post-vaccinal thrombocytopenic purpura.

Possible adverse effects

The type and frequency of adverse events from the vaccine do not differ significantly from the vaccine reactions described separately.

For whole cell diphtheria, tetanus and pertussis (or pertussis) vaccine, slight local or systemic reactions are common including temporary edema, increased sensitivity and erythema (redness) at the injection site altogether with fever occur in a large proportion of cases.

Occasionally severe reactions of high fever, irritability, and unchanged crying may appear within 24 hours of administration. The hypotonic-hyporesponsive episode (HHE) and febrile seizures have been reported, at a rate of one in 12,500 doses administered.

A study in the UK showed a small increase in acute encephalopathy (mainly seizures) after immunization with the diphtheria, tetanus and pertussis vaccine.

However, detailed subsequent reviews of all available studies by expert groups from the Institute of Medicine and the United States Advisory Committee on Immunization Practices (CICC) concluded that the results did not show a causal relationship between DTP vaccine and immunization. chronic dysfunction of the nervous system.

Thus, there is no scientific evidence that these reactions lead to permanent consequences for children.

The hepatitis B vaccine is a well-tolerated vaccine. In placebo-controlled studies, with the exception of local pain, symptoms such as myalgia and transient fever have not been more frequent than in the placebo group. Reports of serious anaphylactic reactions are very rare.

General manifestations such as fever, irritability, fatigue, dizziness, headache, gastrointestinal discomfort, can also occur within the first 24 hours and with benign evolution.

Idiopathic thrombocytopenic purpura (ITP) after vaccination is a rare event whose causal relationship is difficult to ascertain.

The latency time between the onset of symptoms, which is generally a few days to two months, suggests this relationship.

With the Haemophilus influenzae type b vaccine, localized, mild and transient reactions can occur within 24 hours after vaccination, such as pain and increased sensitivity at the injection site, which in most cases disappear spontaneously within 2 to 3 days.

In the case of secondary bacterial contamination due to technical failure of the vaccine application, local abscesses may occur.

General manifestations, such as fever, rarely occur and more serious reactions are very rare, and a causal relationship between more serious reactions and the vaccine has not been established.

Where to find the pentavalent vaccine?

The vaccine is available on public and private networks. Some medical agreements cover this vaccine in the particular health system. Check with your carrier to see if your plan offers this coverage.

Frequent questions

Are there tests that can identify if we are immunized?

Live pathogen vaccines, which can cause disease, can only be identified by blood tests, but this is not medically relevant.

This is because the only way to verify that a person is vaccinated or not is by presenting the record in the portfolio.

The Ministry of Health only considers valid vaccine that in which the registry was properly accredited by an authorized corporation.

Can I update my vaccination record at any age?

Not only can, as it should. Although the ideal is to follow the vaccination schedule and be immunized at the recommended ages, it is important to take vaccines that are delayed.

However, this rule only applies to vaccines that continue to be recommended in adulthood, such as hepatitis B, tetanus, whooping cough, and diphtheria.

Even classic childhood diseases, such as mumps, measles, and rubella, still have the adult vaccine recommendation and need to be taken.

However, vaccines that you should have taken during childhood only, and that lose the recommendation for adults, since the risk of the disease no longer exists, do not need to be taken.

An example is rotavirus, a disease that is very serious in childhood and must be vaccinated in the period, but that for adults does not cause an impact beyond comfort, losing the need for vaccination.

If I don’t remember taking the vaccine, can I go to the post and repeat the dose?

Yes. The best measure to do in these cases is to confer the vaccination letter. But if you lost it for some reason, or then you thought you were vaccinated, but it does not appear in the registry, the best thing to do is to get vaccinated, albeit repeatedly.

If I take the combined vaccine, do I have to take it individually?

Combination vaccines are a set of several vaccines in one, the name says so.

By taking it, you are already adequately immunized for all the diseases listed in the vaccine, not needing to be vaccinated for a disease in isolation, an example would be to take the triple viral and then a tetanus-only vaccine.

However, you may be asked to take the vaccine again in isolation in case of need for a booster due to time or exposure to one of the particular pathogens, such as a measles epidemic.

Can I take the vaccines before the specified time?

No, the minimum ages must be respected. There is probably no risk of getting vaccinated early, but there are no safety studies for an age group, as well as no indication of the vaccine.

The age indications take into account the epidemiological recommendation, that is, the period of life in which you are most at risk of suffering from this disease or its complications.

Therefore, some childhood vaccines no longer need to be administered to adults, since the risk period has already passed. The logic is the same for adult-only vaccines.

Will people with an allergy to a vaccine never be able to take it again?

In general, it is very difficult for a person to be allergic to the vaccine itself, but to other elements that are within it.

Contraindications exist only for people who have already suffered anaphylactic shock in the following cases:

  • Measles, mumps, rubella and yellow fever vaccines were contraindicated for egg anaphylaxis, since these live viruses are cultured in food before going to the vaccine.
  • In cases of mercury anaphylaxis, vaccines with this element are contraindicated, generally those administered by the SUS.
  • Those who have already had anaphylactic shock due to latex should inquire about the vaccines at their standard vaccination site, as some may contain traces of the substance.