Diphtheria causes a severe sore throat, with a thick coating on the tonsils and the back of the throat. It can lead to breathing problems, paralysis, heart failure, and even death. Diphtheria is now very rare in England and Wales. Between 2001 and 2010, there were on average 9 suspected cases and one laboratory proven case per year. The most recent fatal case was in 2008 in London: an unimmunised schoolchild who had come to the UK in 2007 and had recent family contact with Africa. Without immunisation, there would be thousands of cases in children each year.

Tetanus (Lockjaw) causes painful spasms of muscles, usually all over the body. It can lead to “locking” of the jaw so the victim cannot open their mouth or swallow. Tetanus leads to death in about 1 out of 10 cases. There have been only 3 cases of tetanus in children reported in England and Wales since 2000, whereas there were 30 - 60 deaths from tetanus per year in England before tetanus immunisation was introduced in the 1950s.

Whooping Cough (Pertussis) causes coughing spells that make it hard for infants to eat, drink, or breathe. The coughing can last for 6 weeks. It can lead to pneumonia, fits, brain damage, and death. Immunisation prevents these complications and is good at providing protection to babies under 8 weeks of age who are too young to be immunised. In England and Wales in 2008 less than 300 of the notified cases were in infants under the age of 1 year, when the infection is most severe. When immunisation levels fell in the 1970s, the number of reported cases rose to more than 50,000 cases per year.

Polio is a viral infection which causes paralysis (can't move the muscles of the arms, legs or chest). Infection can be fatal, if the paralysis affects muscles that are used for breathing. Polio has been one of the commonest causes of lameness in the world. Before the polio vaccine was introduced in the UK in the late 1950s, the amount of polio varied depending on whether there was an epidemic or not. In England and Wales, the number of reported cases ranged from 1500 to 7500 per year in England and Wales. About 7 out of 10 cases had paralysis and 1 out of 10 died. Since polio vaccine became part of the routine childhood immunisations, thedisease has become very rare in the UK (no cases in the last 10 years). Global eradication of polio is one of the goals of the international health campaigns.

Haemophilus Influenzae Type B (Hib) disease is a life-threatening infection caused by one type of common bacteria. The disease occurs in children under 5 years old. The bacteria are normally carried in the nose and throat, and are spread from person to person by coughing and sneezing. If the bacteria stay in the child's nose and throat, the child will not be ill. But sometimes the bacteria spread into the lungs or the bloodstream, and then Hib can cause serious problems. Before Hib vaccine, Hib disease was the leading cause of bacterial meningitis among young children under 5 years old in the United Kingdom. Hib infection can cause pneumonia, epiglottitis (a severe swelling in the throat making it hard to breathe) or inflammation of joints. Before the Hib vaccine, about 1 in every 600 children had Hib disease before they reached their fifth birthday. 

Diphtheria, tetanus, whooping cough, polio and Hib disease are serious infections and can be prevented by DTaP/IPV/Hib vaccine. Most children who are immunised will be protected throughout childhood. 

Children are offered 3 doses of DTaP/IPV/Hib vaccine, one dose at each of the following ages:

Talk with your doctor if your child:

Ask your doctor, practice nurse or health visitor for advice on any special precautions to be taken for such children.

Catching diphtheria, tetanus, whooping cough, polio or Hib disease is much riskier than having DTaP/IPV/Hib vaccine.

Mild Problems: Common within a day or two after the injection but settle quickly

Intermediate Problems: Uncommon, less than 1 in 1000

Severe Problems: Very Rare

Controlling fever is especially important for children who have had fits for any reason. You can reduce fever and pain by giving your child paracetamol or ibuprofen syrup.

What to look for

Any unusual conditions, such as a serious allergic reaction or high fever. Serious allergic reactions are extremely rare with any vaccine. If one were to occur, it would most likely be within a few minutes to a few hours after the injection. Signs can include difficulty in breathing, hoarseness or wheezing, a rash like a nettle sting, paleness, weakness, a fast pulse or dizziness. If a high fever or fit occurs, it would usually be within a week after the injection.

What to do

Ask your doctor or health visitor. They can suggest other sources of information and they can obtain more advice for you from the local immunisation co-ordinator or health protection unit. For further information sources see 'Resources' section.

Last reviewed June2011.

Last updated June 2011.