How Do Combo Vaccines Work?

Combo vaccines are combinations of two or more vaccines. Vaccines are biologic products that provide protection against infectious diseases. Routine childhood immunization with vaccines has reduced the incidence of many deadly infectious diseases that were common and caused considerable morbidity and mortality in the past.

Vaccines work by stimulating the body’s immune system to produce antibodies against specific disease-causing organisms, and protect a person from becoming infected when exposed to these germs. The main component of vaccines is the antigen from specific organisms that generate immune responses to the particular organisms.

Vaccines are purified preparations from weakened or inactivated organisms, the proteins or toxins they produce, or from fragments of genetic material. Some vaccines are synthetically produced to resemble disease-causing pathogens. Vaccines also contain substances that preserve and stabilize the vaccine and boost immune response.

Combo vaccines provide immunity against two or more of the following diseases:

• Diphtheria, caused by Corynebacterium diphtheriae bacteria
• Tetanus, caused by Clostridium tetani bacteria
• Pertussis (whooping cough) caused by Bordetella pertussis bacteria
• Polio (poliomyelitis) caused by poliovirus
• Haemophilus influenzae type B (Hib) bacterial infection
• Hepatitis B virus (HBV) infection

Combo vaccines approved by the FDA for use in the USA include:

• Diphtheria and tetanus toxoids (bacterial toxins chemically altered to remove their toxicity)
• Diphtheria and tetanus toxoids and acellular pertussis vaccine
• Diphtheria and tetanus toxoids, acellular pertussis, inactivated poliovirus, and Haemophilus influenzae type B vaccine
• Diphtheria and tetanus toxoids, acellular pertussis, inactivated poliovirus, and hepatitis B vaccine
• Diphtheria and tetanus toxoids, acellular pertussis, inactivated poliovirus, hepatitis B, and Haemophilus influenzae type B vaccine
• Diphtheria and tetanus toxoids, acellular pertussis, inactivated poliovirus vaccine
• Hepatitis B and Haemophilus influenzae type B vaccine
• Tetanus and reduced diphtheria toxoids and acellular pertussis vaccine

Combo vaccines are administered as intramuscular injections in a series of doses on a prescribed schedule, mostly as routine immunization in children and adolescents. Adults who have not received primary immunization in childhood may be administered tetanus, diphtheria, and pertussis vaccines.

Combo vaccines are approved by the FDA for use in:

Children and adolescents

• Primary and booster immunization against diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type B, and hepatitis B virus infections
• Prophylaxis after exposure to diphtheria
• Tetanus and diphtheria prophylaxis in wound management
• Catch-up vaccination for children and adolescents, who were not fully immunized before age 7 against tetanus, diphtheria, and pertussis
• Immunization during pregnancy in adolescents against tetanus, diphtheria, and pertussis

Adults 

• Primary and booster immunization against diphtheria and tetanus
• Prophylaxis after exposure to diphtheria
• Tetanus and diphtheria prophylaxis in wound management
• Booster immunization against tetanus, diphtheria, and pertussis
• Immunization during pregnancy against tetanus, diphtheria, and pertussis

Side effects of combo vaccines may include the following:

• Injection site reactions include:
  • Erythema (redness)
  • Swelling
  • Pain and soreness
  • Tenderness and warmth
  • Inflammation
  • Mass
  • Induration (hardening of the tissue)
  • Edema
  • Pruritus (itching)
  • Cellulitis
• Muscle weakness
• Headache
• Body aches
• Malaise
• Sore and swollen joints
• Fever
• Chills
• Lethargy and reduced activity
• Fatigue
• Inconsolable crying
• Irritability and fussiness
• Restlessness
• Somnolence (drowsiness)
• Decreased consciousness
• Decreased appetite
• Anorexia (loss of appetite)
• Vomiting
• Diarrhea
• Nausea
• Constipation
• Gastrointestinal symptoms
• Candidiasis (Candida infection)
• Otitis media (middle ear infection/inflammation)
• Ear pain
• Rhinorrhea (nasal discharge)
• Congestion
• Upper respiratory tract infection
• Bronchiolitis (inflammation of the small airways in the lungs)
• Cough
• Asthma
• Lymphadenopathy (lymph node swelling)
• Encephalopathy (brain tissue damage)
• Cerebrovascular accident
• Hypersensitivity reactions such as:
  • Rash
  • Erythematous rash (rash with redness of the skin)
  • Maculopapular rash (flat lesions with raised bumps)
  • Erythema multiforme (round lesions like a bullseye)
  • Urticaria (hives)
  • Pruritus (itching)
  • Angioedema (swelling in the tissue under the skin or mucous membranes)
  • Face edema
  • Bronchospasm
  • Apnea (cessation of breathing)
  • Dyspnea (shortness of breath)
  • Shock
• Cyanosis (bluish skin color due to low oxygen)
• Peripheral edema
• Limb swelling and pain
• Pain in extremities
• Myalgia (muscle pain)
• Hypotonia (reduced muscle tone)
• Paresthesia (abnormal skin sensation)
• Dizziness
• Syncope (fainting)
• Guillain-Barre syndrome (neurological disorder)
• Peripheral neuropathy (damage to peripheral nerves)
• Brachial neuritis (inflammation of brachial nerves, a group of nerves that innervate chest, shoulders, arms, and hands)
• Seizure
• Febrile seizure (convulsion caused by fever)
• Liver function test abnormalities
• Dehydration
• Hyponatremia (low sodium level in the blood)
• Thrombocytopenia (low platelet count in the blood)

Information contained herein is not intended to cover all possible side effects, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Check with your doctor or pharmacist to make sure these drugs do not cause any harm when you take them along with other medicines. Never stop taking your medication and never change your dose or frequency without consulting your doctor.

Generic and brand names of combo vaccines include:

• Adacel
• Boostrix
• Comvax
• Daptacel
• Decavac (DSC)
• diphtheria & tetanus toxoids
• diphtheria & tetanus toxoids/ acellular pertussis vaccine
• diphtheria & tetanus toxoids/ acellular pertussis/ poliovirus, inactivated/ Haemophilus B vaccine
• diphtheria & tetanus toxoids/ acellular pertussis/ poliovirus, inactivated/ hepatitis B vaccine
• diphtheria & tetanus toxoids/acellular pertussis vaccine/poliovirus vaccine inactivated/hepatitis b/haemophilus influenzae type b vaccine
• diphtheria & tetanus toxoids/acellular pertussis/poliovirus, inactivated vaccine
• DT
• DTaP/ IPV
• DTaP/ IPV/ HepB
• DTaP/ IPV/ Hib
• DTaP/hepatitis B/inactivated poliovirus vaccine
• DTaP/IPV/Hep B/Hib
• hepatitis b vaccine/haemophilus influenzae type b vaccine
• HIB/Hep B Vaccine
• Infanrix
• Kinrix
• Pediarix
• Pentacel
• Quadracel
• Td
• Tdap
• TDVAX
• Tenivac
• tetanus & reduced diphtheria toxoids/ acellular pertussis vaccine
• Vaxelis