Hexavalent vaccine in newborns

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In this article

  • What is it
  • How you do it
  • When you do
  • risks
  • Who can not get vaccinated

What is

Il hexavalent vaccine is a single vaccine that simultaneously protects against six diseases:

  1. diphtheria,
  2. tetanus,
  3. whooping cough,
  4. polio,
  5. hepatitis B
  6. invasive Haemophilus influenzae type B (HiB) diseases.

How it is administered

With a single sting (to be repeated three times during the first year of life), children are therefore protected from six diseases which, however rare they may appear to us, can be extremely dangerous.

On the other hand, even if thinking about six diseases all together can be frightening, the "load" placed by this vaccine on the immune system is by no means unsustainable. The vaccine works because it contains antigens, that is, particles capable of stimulating the immune system. Well, the antigens contained in the hexavalent are in all 23. For comparison, just think that in the first hours of life a newborn comes into contact with over a million different antigens!

Read also: Vaccinations for children: DO NOT weaken the immune system

Diseases preventable with hexavalent


Very contagious infectious disease which, especially in children under one year of age, can cause serious complications, with disabling and permanent damage and in some cases death. To protect infants who still cannot be vaccinated, vaccination of the pregnant mother, around 28 weeks, is highly recommended.


Severe infectious disease caused by a bacterial toxin. It can have various manifestations, but the most typical is a severe sore throat, which can rapidly progress causing infections in the respiratory, heart and kidney and nervous system, with possible life-threatening complications.


Non-contagious infectious disease caused by a bacterial toxin. It is a painful disease, which involves muscle spasms and stiffness that can affect the respiratory muscles, even causing death (in 10-20% of cases).

Diseases caused by Haemophilus influenzae type B (Hib)

Group of infectious diseases caused by a bacterium that can affect several organs. Symptoms are generally mild, flu-like, but in some cases the infection can develop into diseases such as arthritis, ear infections, pneumonia, meningitis, blood infection, and more, with the risk of serious complications and death.


Serious illness caused by a virus that attacks the nervous system. It can be asymptomatic or mild, with flu-like symptoms. In some cases, however, it involves brain infections and paralysis that can even be permanent. If muscles important for vital functions are affected, it can even be fatal.

Hepatitis B

Infectious disease caused by a virus that affects the liver causing loss of appetite, nausea, jaundice and joint pain. In some people, the infection can become chronic and lead to cirrhosis, which can progress to death.

Also Read: 15 Vaccine-Preventable Diseases

How the hexavalent vaccine is made

It is a'intramuscular injection, which is practiced in the front of the thigh muscle.

When you do

The hexavalent is typically the first vaccine made to a child, and can be administered from the 60th day of life.

The vaccination schedule provides three doses:

  1. one during the third month of life,
  2. one in the fifth month
  3. and the last in the course of the eleventh month of life.

Only with the three doses is full coverage against diseases preventable by this vaccine achieved.

Hexavalent is one of the Compulsory vaccines provided for by the Lorenzin law on vaccines. Or rather, vaccinations against the six diseases that the vaccine prevents (in addition to four others: measles, mumps, rubella, chicken pox) are mandatory. For these six diseases, however, the obligation is typically fulfilled with this vaccine.

What are the risks

The hexavalent vaccine is considered to be a very safe vaccine. Which does not mean that it can never cause any adverse effects. Even this vaccine, like all vaccines and drugs, is not without potential risks, although the more serious ones are extremely rare.

According to official documents of the World Health Organization and the Del Paesena drug agency, the most common adverse reactions caused by vaccination with hexavalent are:

  • drowsiness,
  • lack of appetite,
  • He retched,
  • hardening,
  • redness or swelling of the injection site,
  • temperature,
  • irritability.

Any more serious reactions are much rarer: episodes of convulsions, for example, can occur in one case every 200 thousand vaccinations. Severe hypoallergenic reactions (anaphylaxis) or neuritis, on the other hand, can occur in 5-6 cases per million vaccinations.

For comparison, we also remember the mortality risk from the six diseases preventable with hexavalent:

  • diphtheria: 2-10%
  • tetanus: 10-20%
  • whooping cough: 0,5%
  • hepatitis B: 2% for chronic forms
  • HiB: 5%
  • polio: 2-10%
Also read: 5 things you (maybe) don't know about vaccines

Who can not get vaccinated

Vaccination with hexavalent is contraindicated for children who have had a severe allergic reaction to the vaccine itself or its components after the administration of a previous dose.

Furthermore, vaccination will be postponed in case of severe illness (not if there is a cold a little fever) and if after the administration of a previous dose serious conditions have occurred (for example an encephalopathy or peripheral neuropathy ), yet to be clarified. It is by no means certain that those conditions were caused by the vaccine, but as a precaution it is better to wait for further investigations.

Sources for this article

ISS Documents Pediatric Vaccinations, the difficult questions; information material on the Epicenter website of the Higher Institute of Health; Vaccination plan 2022-2022; Guide to contraindications to vaccinations, edited by experts from various scientific societies.

  • adverse reactions to vaccines
  • contraindications to vaccines
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