5-in-1 and 6-in-1 Vaccines

What are the 5-in-1 and 6-in-1 vaccines?

The 5-in-1 and 6-in-1 vaccines are combination immunisations designed to protect infants against multiple serious infectious diseases with fewer injections. These vaccines are part of Singapore’s National Childhood Immunisation Schedule (NCIS) and are widely recommended by healthcare authorities worldwide for early childhood protection.

5-in-1 vaccine

The 5-in-1 vaccine combines five different vaccines into a single injection. It protects against:

• Diphtheria — a bacterial infection that can cause severe breathing problems, heart failure, and nerve damage. Though rare today due to vaccination, diphtheria can be fatal without prompt treatment.

• Tetanus — caused by bacteria found in soil, dust, and animal waste. It enters through cuts or wounds and leads to painful muscle stiffness and spasms. Unlike many other diseases, tetanus is not spread from person to person, so vaccination is the only effective prevention.

• Pertussis (Whooping Cough) — a highly contagious respiratory disease that causes intense coughing fits, making it difficult for babies to eat, drink, or breathe. It can lead to pneumonia, seizures, brain damage, and death in infants.

• Poliomyelitis (Polio) — a viral disease that attacks the nervous system and can lead to permanent paralysis. Although polio has been eradicated in many countries, it still exists in some regions, which makes vaccination vital for global eradication efforts.

• Haemophilus influenzae type b (Hib) — a bacterial infection that can cause meningitis, pneumonia, and epiglottitis. It can develop rapidly and be fatal in young children if not treated promptly.

The 5-in-1 vaccine is typically administered in a three-dose schedule at 3, 4, and 5 months of age.

6-in-1 vaccine

The 6-in-1 vaccine offers the same protection as the 5-in-1, with the addition of immunity against Hepatitis B, a viral infection that affects the liver. Infants infected at birth are at high risk of developing chronic hepatitis B, which can lead to liver cirrhosis and cancer later in life. 

The 6-in-1 vaccine is generally given at 2, 4, and 6 months of age. It is often preferred due to its broader protection and compatibility with the infant vaccination timeline, as it allows for earlier immunisation against Hepatitis B, a disease that can be transmitted from mother to child at birth.

How do the 5-in-1 and 6-in-1 vaccines work?

The 5-in-1 and 6-in-1 vaccines work by training your child’s immune system to recognise, and respond to specific disease-causing bacteria and viruses, without actually causing the illness. Each vaccine contains safe, inactivated, or purified components from the targeted pathogens, which are enough to stimulate the body to develop protective antibodies.

These antibodies help your child’s immune system “remember” the infection. If they are exposed to the actual disease in the future, their body can respond quickly to fight it off, often before symptoms even develop.

What sets these vaccines apart is that they combine multiple protections into one injection. This approach reduces the number of injections required during the early months of life, while still offering strong, effective immunity.

The 5-in-1 vaccine targets five serious childhood diseases in one shot, and the 6-in-1 vaccine does the same with the added protection against hepatitis B, which makes it a more comprehensive option for some children.

Why are 5-in-1 or 6-in-1 vaccines important for my child?

The 5-in-1 and 6-in-1 vaccines offer several important advantages, not only in protecting your child against serious diseases but also in making the immunisation process simpler and more manageable for both parents and healthcare providers.

• Fewer injections, less discomfort  — by combining multiple vaccines into one, your child needs fewer jabs, which reduces pain, anxiety, and distress during vaccination visits.

• Early and broad protection  — both vaccines are given in the first few months of life, a time when infants are most vulnerable to infections. The 6-in-1 vaccine adds protection against hepatitis B, offering a more comprehensive shield at an earlier stage.

• Improved compliance with the immunisation schedule  — fewer appointments and injections make it easier to stay on track with Singapore’s National Childhood Immunisation Schedule (NCIS) and helps ensure that your child receives timely protection.

• Reduced risk of delays or missed doses  — simplified vaccination schedule helps prevent missed or delayed doses, which could leave your child unprotected during critical developmental periods.

• Safe and well-established  — both vaccines have undergone extensive safety testing and are used in national immunisation programmes worldwide. Side effects are typically mild and short-lived.

• Efficient for parents and doctors  — combination vaccines reduce the number of clinic visits needed, which is especially helpful for busy families. For doctors, it streamlines the vaccination process without compromising safety or effectiveness.

When should my child receive the 5-in-1 or 6-in-1 vaccine?

​The 5-in-1 and 6-in-1 vaccines are given during your child’s first year of life to protect against multiple serious diseases at a time when their immune system is still developing. These schedules are part of Singapore’s National Childhood Immunisation Schedule (NCIS) and are designed to offer early and effective protection.

Vaccine Schedule

Both vaccines are safe, effective, and approved under Singapore’s national guidelines. Your child’s doctor may recommend one over the other based on their individual vaccination history, especially if hepatitis B doses have already been given at birth and 1 month.

What are the possible side effects of the 5-in-1 and 6-in-1 vaccines?

The 5-in-1 and 6-in-1 vaccines are generally well tolerated by infants. Like all vaccinations, they may cause some mild side effects, which are usually short-lived and not a cause for concern. These effects are a natural response as your child’s immune system begins to build protection against the targeted diseases.

Common side effects

Most babies experience only mild symptoms after receiving the vaccine. These may include:

• Slight fever, typically under 38.5°C, occurring within 24 hours
• Redness, swelling, or tenderness at the injection site
• Increased fussiness or irritability
• Tiredness or sleepiness
• Temporary loss of appetite

These symptoms usually resolve within a day or two without any treatment. If needed, infant paracetamol may be given to manage mild fever or discomfort,  but only under the guidance of a doctor.

Less common or rare side effects

In a small number of cases, children may experience:

• Persistent crying for over three hours (very rare)
• High fever (above 39°C)
• Seizure associated with fever (febrile seizure), but it is rare and typically not harmful in the long term
• Allergic reactions, such as a rash, swelling of the face, or difficulty breathing, but it is  extremely rare (approximately 1 in a million doses)

Medical staff are trained to recognise and respond to serious allergic reactions immediately, although such cases are extremely uncommon.

What should I do after my child receives the 5-in-1 or 6-in-1 vaccines?

After your child receives the 5-in-1 or 6-in-1 vaccine, there are a few simple steps you can take to help them feel more comfortable and to monitor for any common post-vaccination responses. Most children recover quickly with little to no disruption to their routine.

• Keep your child comfortable — dress your child in loose, comfortable clothing, particularly around the injection site to minimise irritation. If your baby seems fussy or unsettled, comforting them through cuddling, holding, or breastfeeding can help them feel more secure. Continue with regular feeds and ensure they stay well hydrated throughout the day.

• Monitor for side effects — over the next 24–48 hours, it’s normal for your child to have mild fever, slight redness or swelling at the injection site, and fussiness or tiredness. These side effects are short-lived. You can give infant paracetamol if recommended by your doctor to reduce fever or discomfort, but avoid using medication unless advised.

• Avoid strenuous activity — if your child is older and active, try to keep playtime calm for the rest of the day. For babies, there’s no need to cancel naps or feeds, just follow their usual routine.

• Know when to seek medical advice — contact your doctor if your child experiences:
  • A fever above 39°C that does not go down
  • Persistent crying for more than 3 hours
  • Severe swelling at the injection site
  • Signs of an allergic reaction (such as difficulty breathing, rash, or swelling of the face/lips)

What happens if my child misses their 5-in-1 or 6-in-1 vaccine?

If your child happens to miss their scheduled vaccination dose, it is important to let your doctor know and catch up as soon as possible. Things to note include:

• Vaccination should not be restarted — there is no need to repeat earlier doses. Even if a dose is delayed, it is just recommended that your child resume the schedule as soon as possible from where they left off.

• Catch-up dose — your doctor will plan the next steps for a catch-up dose depending on how many doses have been missed, your child’s age and the interval between doses.

Summary 

The 5-in-1 and 6-in-1 vaccines are essential childhood immunisations that protect infants from multiple serious diseases with fewer injections. Offered as part of Singapore’s National Childhood Immunisation Schedule, these combination vaccines are safe, effective, and widely used around the world. They help build early immunity, reduce clinic visits, and simplify the vaccination process for parents and babies.

At Phoenix Medical Group, we offer the 5-in-1 and 6-in-1 vaccinations, along with guidance through your child’s vaccination journey, answers to your questions, and personalised care you can trust. Contact us to schedule your child’s 5-in-1 or 6-in-1 today.

Frequently Asked Questions (FAQs) 

Can my child receive the 6-in-1 vaccine if they have already started the 5-in-1 schedule?

It’s generally recommended to complete the vaccination schedule with the same type of vaccine. However, in certain circumstances, your healthcare provider may advise transitioning to the 6-in-1 vaccine. It’s essential to consult with your doctor to determine the best course of action for your child's immunisation.​

Are there any medical conditions that would prevent my child from receiving these vaccines?

Most children can safely receive the 5-in-1 and 6-in-1 vaccines. However, if your child has had a severe allergic reaction to a previous dose or to any component of the vaccine, or if they have a condition that affects their immune system, it’s crucial to discuss this with your healthcare provider. They can assess your child’s medical history and provide guidance on the safest options.​

How effective are the 5-in-1 and 6-in-1 vaccines?

Both vaccines are highly effective in protecting against the diseases they target. They produce a strong immune response, which significantly reduces the risk of infection. 

Can 5-in-1 and 6-in-1 vaccines be administered alongside other routine childhood vaccinations?

Yes, the 5-in-1 and 6-in-1 vaccines can be given at the same time as other routine childhood immunisations, such as the rotavirus or pneumococcal vaccines. Administering multiple vaccines during a single visit is safe and helps ensure that your child stays up to date with their immunisation schedule.​