Skip to main content

Diphtheria, tetanus, pertussis (whooping cough) and polio (dTaP/IPV or, '4-in-1' vaccine)

The dTaP/IPV vaccine, also commonly known as the ‘4-in-1’ vaccine, helps protect against four serious diseases: Diphtheria, tetanus, pertussis (whooping cough) and polio.

On this page


The dTaP/IPV vaccine, also commonly known as the ‘4-in-1’ vaccine, helps protect against four serious diseases: Diphtheria, tetanus, pertussis (whooping cough) and polio.


Diphtheria is a serious disease, caused by a type of bacteria (Corynebacterium diphtheria). Diphtheria usually begins with a sore throat and can quickly cause breathing problems. It can damage the heart and nervous system and, in severe cases, can kill. It is rare in the UK, however it is possible to catch it while travelling in various regions of the world.

NHS 111 Wales - Diphtheria (external site)


Tetanus is a disease affecting the nervous system, which can cause muscle spasms, and breathing problems and can kill. It is caused when bacteria (Clostridium tetani) found in soil and manure get into the body through open wounds.

NHS 111 Wales - Tetanus (external site)

Whooping cough

Whooping cough (pertussis) is caused by a type of bacteria (Bordetella pertussis). It is a bacterial infection of the lungs and breathing tubes, and can cause long bouts of coughing and choking, making breathing difficult. Whooping cough is very easily spread.

NHS 111 Wales -Whooping cough (external site)


Polio is a virus that can attack the nervous system and can cause permanent paralysis of the muscles. If it affects the chest muscles or the brain, polio can kill. Polio was once common in the UK and throughout the world. It is now rare because it can be prevented with vaccination.

NHS 111 Wales - Polio (external site)

The '4-in-1' vaccine

The ‘4-in-1’ vaccine is highly effective and boosts immunity to diphtheria, tetanus, pertussis (whooping cough) and polio infections.

The vaccine boosts the protection from the immunisations that were given to your child at 8, 12 and 16 weeks of age.

The ‘4-in-1’ vaccine is also offered to women during pregnancy so that protection against whooping cough is passed from mother to baby. This protects babies in the first months of life before they are old enough to have their first vaccination.

NHS 111 Wales - 4 in 1 pre-school booster (external site)


Eligibility for the vaccine

The ‘4-in-1’ vaccine is offered to all children and pregnant women as part of the routine immunisation programme in Wales. It is also offered in some occupational health circumstances.

Child immunisations

The ‘4-in-1’ vaccine is routinely offered to children from the age of three years and four months old alongside a second dose of MMR vaccine as part of their ‘pre-school boosters’.

Pregnancy immunisations

The ‘4-in-1’ vaccine is offered to pregnant women between 16 to 32 weeks of pregnancy to help protect the baby from whooping cough in the first few months of life before they receive their first immunisations.

Occupational vaccines

To help protect babies from whooping cough, healthcare workers in NHS Wales who have not received a pertussis-containing vaccine in the last 5 years and who have regular contact with pregnant women and/or young babies are eligible for a pertussis containing vaccine as part of their occupational health care.

Tetanus prone wounds

Children with a tetanus prone wound (see bullets below) may be offered a dose of the ‘4-in-1’ vaccine.

Contact a GP or visit the nearest minor injury or A&E department if you’re concerned about a wound, particularly if:

  • It’s a deep wound
  • There’s dirt or something inside the wound
  • You or your child are not fully vaccinated for tetanus, or you’re not sure.

A doctor will assess the wound and decide whether treatment is needed. If not fully vaccinated for tetanus, a dose of tetanus containing vaccine may be given.

If you have any questions about the ‘4-in-1’ vaccine, or you are unsure about when it should be given, you can contact your GP surgery for advice.


About the 4 in 1 vaccine

Children and adults will normally be given the ‘4-in-1’ vaccine as an injection into the upper part of their arm.

The ‘4-in-1’ vaccine currently available in the UK is known under the brand name Boostrix-IPV.

If your child has missed an appointment for the ‘4-in-1’ vaccination speak to your GP or practice nurse for advice. Eligible healthcare workers who have missed the vaccination can speak to their Occupational health department for advice.

Information about other vaccinations against diphtheria, tetanus, pertussis and polio can be found on the following pages:

Side effects of the ‘4-in-1’ vaccine

Although it is very safe, the ‘4-in-1’ vaccine like other vaccines, can have side effects. Common side effects include:

  • mild fever
  • loss of appetite
  • irritability
  • headache
  • sleepiness
  • pain, redness and swelling at the injection site.

Other reactions are rare. For more information on common and rare side effects see:

If you are concerned about symptoms call NHS 111 Wales (external site). Calls to NHS 111 Wales are free from landlines and mobile phones.

You can report suspected side effects of vaccines and medicines through the Yellow Card scheme. You can do this online at or by calling the Yellow Card scheme hotline on 0800 731 6789 (Monday to Friday, 9am to 5pm).  


Information for the public

If you would like to learn more about the vaccine or the diseases it protects against, a number of information resources are available to help. You can also call NHS 111 or your GP practice for advice if you have any questions.


More information

NHS 111 Wales - 4-in-1 vaccine FAQs (external site)