Do Not Use Pentacel for a 4-Year-Old Child
For a 4-year-old child due for their 4th DTaP dose, you cannot use Pentacel because it is not licensed for use in children aged 5 years or older, and the 4th DTaP dose at age 4-6 years requires a different vaccine formulation. 1, 2, 3
Critical Age and Licensing Restrictions
Pentacel (DTaP-IPV/Hib) is only licensed for children aged 6 weeks through 4 years (up to 4 years, 364 days) and is specifically indicated for doses at ages 2,4,6, and 15-18 months—NOT for the booster dose at age 4-6 years. 1, 3
The age restriction exists because Pentacel contains the Haemophilus influenzae type b (Hib) component, which is not indicated beyond age 4 years in healthy children. 3
Understanding the DTaP Schedule
The complete DTaP series consists of 5 doses: 1, 2
- Doses 1-3: Ages 2,4, and 6 months (primary series)
- Dose 4: Age 15-18 months (toddler booster)
- Dose 5: Age 4-6 years (preschool booster)
Correct Vaccine Selection for a 4-Year-Old
For children aged 4-6 years who need their 5th DTaP dose and 4th IPV dose, use Kinrix (DTaP-IPV) or Quadracel (DTaP-IPV). 4, 3
- Kinrix is specifically licensed for the 5th DTaP dose and 4th IPV dose in children aged 4-6 years. 4, 3
- Quadracel is licensed for the 5th DTaP dose and 4th or 5th IPV dose in children aged 4-6 years who previously received Pentacel and/or Daptacel. 3
When Pentacel IS Appropriate
Pentacel should be used for the 4th dose when given at 15-18 months of age (not at 4-6 years). 2, 5, 6, 7
- The 4th dose may be administered as early as 12 months if there is concern about missing a vaccination opportunity, provided 6 months has elapsed since the 3rd dose. 1, 2
- Pentacel at ages 2,4,6, and 15-18 months provides complete primary immunization against diphtheria, tetanus, pertussis, polio, and Hib. 5, 6, 7
Pediarix Clarification
Note: Pediarix (DTaP-IPV-HepB) is a different combination vaccine that contains hepatitis B instead of Hib. It is also not appropriate for the 4-6 year booster dose, as it is licensed for the first 3 doses of the DTaP series (at 2,4, and 6 months). 8
Common Pitfall to Avoid
If Pentacel is inadvertently administered to a child aged >5 years, it should be counted as a valid dose and does not need to be repeated. 1 However, this should be avoided through proper vaccine selection based on the child's age at the time of administration.
Interchangeability Consideration
While the same manufacturer's DTaP vaccine should be used throughout the series whenever feasible, vaccination should never be deferred if the specific brand previously administered is unavailable or unknown. 1, 4