Safety of the intervention
Combination vaccines are widely used in routine immunization programmes and allow multiple vaccine antigens to be administered with fewer injections. Their safety profiles reflect the component antigens and the specific vaccine formulation.
Diphtheria, tetanus and pertussis combination vaccines (DTP) have been in use since the 1940s. More recently, this DTP combination has been used as the basis for the development of combination vaccines containing additional antigens such as hepatitis B and Haemophilus influenzae type b (Hib), resulting in pentavalent vaccines, or with the additional IPV, resulting in hexavalent vaccines.
None of these combination vaccines has produced any adverse events that had not been observed with the individual components and currently used combination vaccines have excellent safety records.Go to footnote 1, Go to footnote 2, Go to footnote 3, Go to footnote 4
- Go back to footnote reference 1
World Health Organization (2022). Polio vaccines: WHO position paper, June 2022. Wkly Epidemiol Rec. 97(25):277–300 (https://www.who.int/publications/i/item/WHO-WER9725-277-300, accessed 29 June 2026).
- Go back to footnote reference 2
Frequently asked questions and considerations for the introduction of hexavalent vaccine DTwP-HepB-Hib-IPV in routine immunization programmes. In: World Health Organization [website]. Geneva: World Health Organization; 2024 (https://www.technet-21.org/en/resources/guidance/frequently-asked-questions-and-considerations-for-the-introduction-of-hexavalent-vaccine-dtwp-hepb-hib-ipv-in-national-immunization-programmes-update-june-2025 , accessed 24 August 2026).
- Go back to footnote reference 3
GACVS report on hexavalent vaccines. In: World Health Organization [website]. Geneva: World Health Organization; 2005 (https://www.who.int/groups/global-advisory-committee-on-vaccine-safety/topics/hexavalent-vaccines , accessed 11 July 2025).
- Go back to footnote reference 4
Sharma H, Parekh S, Pujari P, Kawade A, Lalwani S, et al. A phase III randomized-controlled study of safety and immunogenicity of DTwP-HepB-IPV-Hib vaccine (HEXASIIL®) in infants. npj Vaccines. 2024;9:41. doi:10.1038/s41541-024-00828-w.