A dose of Quadracel (DTaP-IPV) was inadvertently given to a 4-month-old in our practice who needed DTaP and IPV. Can this dose be considered valid?

Both brands of DTaP-IPV pediatric combination vaccines (Kinrix, GSK; Quadracel, Sanofi) are only licensed for use as the fifth dose of the DTaP vaccine series and the fourth (or fifth, for Quadracel) dose of the IPV series in children age 4 through 6 years. CDC has provided this guidance for when Kinrix or Quadracel are given off-label:

• Kinrix or Quadracel given to a child younger than 4 years as DTaP and IPV doses 1, 2, or 3: Count as valid if all minimum intervals met.
• Kinrix or Quadracel given to a child younger than 4 years as DTaP and IPV doses #4 and/or #5: Count as valid for DTaP #4; not valid for DTaP #5 or IPV #4, both of which must be administered at age 4 through 6 years.

However, you should check with your state immunization program to see what they will accept. Checking with your state is particularly important for validating a last dose of IPV vaccine administered before the fourth birthday. Their guidance may vary depending on the date of administration or your upcoming travel plans. Contact information can be found here: www.immunize.org/coordinators.