Can Infanrix Hexa (combined diphtheria, tetanus, pertussis, hepatitis B, Haemophilus influenzae type b, and poliomyelitis vaccine) be used as a substitute for the MMR (Measles, Mumps, Rubella) DTP (Diphtheria, Tetanus, Pertussis) vaccine?

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Last updated: January 14, 2026View editorial policy

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No, Infanrix Hexa Cannot Substitute for MMR Vaccine

Infanrix Hexa cannot be used as a substitute for the MMR (Measles, Mumps, Rubella) vaccine because it does not contain any measles, mumps, or rubella antigens—these are completely different vaccines protecting against different diseases. 1, 2, 3

What Infanrix Hexa Actually Contains

Infanrix Hexa is a hexavalent vaccine that protects against six diseases: 2, 3

  • Diphtheria
  • Tetanus
  • Pertussis (whooping cough)
  • Hepatitis B
  • Poliomyelitis (polio)
  • Haemophilus influenzae type b (Hib)

Infanrix Hexa does cover the DTP component (diphtheria, tetanus, pertussis) but provides zero protection against measles, mumps, or rubella. 2, 3

What Children Actually Need

At age 4-6 years, children require: 4

  • Fifth dose of DTaP (which Infanrix Hexa could theoretically provide if used off-label, though it's licensed only for infants aged ≤6 months) 2, 3
  • Fourth dose of IPV (polio—also in Infanrix Hexa) 4
  • Second dose of MMR (NOT in Infanrix Hexa) 4
  • Second dose of varicella vaccine (NOT in Infanrix Hexa) 4

Critical Clinical Caveat

The Advisory Committee on Immunization Practices explicitly warns against substituting a hexavalent vaccine for vaccines with different antigen compositions, as this results in missing protection against required diseases. 1 Using Infanrix Hexa instead of MMR would leave children completely unprotected against measles, mumps, and rubella—diseases that can cause serious morbidity and mortality. 5

Proper Vaccine Administration

MMR vaccine must be administered as a separate injection and cannot be replaced by any combination vaccine that lacks measles, mumps, and rubella antigens. 5 The MMR vaccine can be given simultaneously with DTaP-containing vaccines at different anatomic sites without compromising immune responses or increasing adverse events. 5

For the 4-6 year visit, use DTaP-IPV combination vaccines (Kinrix or Quadracel) for the DTaP and polio components, but MMR must still be given as a separate injection. 4

References

Guideline

Interchangeability of Hexaxim and Infanrix Vaccines

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Research

Spotlight on DTPa-HBV-IPV/Hib Vaccine (Infanrix hexa).

BioDrugs : clinical immunotherapeutics, biopharmaceuticals and gene therapy, 2010

Guideline

Vaccination Schedule for 4-Year-Olds

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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