New DTaP-Polio Combo Vaccine: Six T-or-F on Quadracel

Sanofi Pasteur recently received approval from the FDA for a new vaccine named Quadracel. It is a combination of Sanofi’s DTaP (Daptacel) and their inactivated polio vaccine (IPOL). Glaxo has a similar combined DTaP-polio vaccine called Kinrix.

Let’s see how much you know about these two vaccines. (For those of you who have started gin and tonic season a little early, we’ll make this quiz a little easier with a true-false format rather than multiple choice.)

1. Both vaccines have the same 3 strains of inactivated polio viruses. T or F

2. Both vaccines have the same 4 strains of pertussis antigens. T or F

3. Because of immune interference, both vaccines have a higher amount of polio antigen in them as compared with the inactivated polio vaccine. T or F

4. The Advisory Committee for Immunization Practices states a preference that the same manufacturer’s DTaP vaccine be used for all of the first 5 doses. T or F

5. If a 7-year-old child with delayed vaccines needs both a DTaP and IPV, you can use either Kinrix or Quadracel to meet this need, thereby reducing by one the number of separate shots this child will need. T or F   

6. If an unvaccinated 4-year-old child is now going to get caught up on vaccines, you can use Quadracel but not Kinrix more than once as you get this child fully vaccinated. T or F

Please make a list of your choices, then click here for answers.

1. TRUE  Not only are the 3 antigens the same (one from each of the 3 wild types of polio) but the amount of the 3 antigens is the same in both vaccines.

2. FALSE  The Sanofi line of DTaP-containing products have 4 pertussis antigens; Glaxo’s has 3 of the 4, but at higher amounts. Which one works better?  Which one lasts longer? These important questions are unanswered, since no head-to-head studies have been conducted and are unlikely to be done in the future because of cost.

3. FALSE  Immune interference was seen in ProQuad trials with a reduced antibody response to the varicella component when the same dose of varicella antigen in Varivax was used combined with the MMR antigens. Merck had to more than triple the dose of varicella antigen added to MMR to get a good varicella antibody response. This was not the case for either of the DTaP-IPV combinations.

4. TRUE  While the ACIP says it is preferable to use the same company’s pertussis vaccine for the first 5 doses, they also state is is OK to use whatever DTaP vaccine you have in your office. No data exist looking at efficacy of using mixed doses from different manufacturers.

5. FALSE  Per the package inserts, both Kinrix and Quadracel are approved only for children aged 4 through 6 years.

6. FALSE  Per the package inserts, both Kinrix and Quadracel are approved only for single use.

References:

For further reference:

Quadracel Prescribing Information

Kinrix Prescribing Information