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Pediatrics/Vaccination Advice


QUESTION: Dear Doctor,

My baby is now 5 months 20 days old. She has been given following vaccination till now:
Birth : OPV & Hep B (BCG vaccination)
1 month: Hep B 2nd dose
40 days: Polio drop on govt booth
2 month 10 days: DTP+IPV+HIB(Pentaxim) & Rotarix1
3 month 25 days: DTP2+IPV2+HIB2(Pentaxim) & Rotarix2

Now, her Pediatric recommends to give vaccination on completion of 5 months 25 days for DTP, Hib and IPV 3rd dose. Also suggested for Hep B. He has also given an option to choose either same pentaxim or easy 4. I would like to know which vaccination I should prefer. Is there any difference between two. Can I choose Hep B with same day or do I need to have some gap between.

Please advice accordingly. Thanks Anshul

ANSWER: Hi Anshul,

Pentaxim is combination of DTaP, IPV and Hib.
Easy 4 is a combination of DTwP and Hib.

Thus, there are 2 differences: One, Easy 4 does not have IPV. If you choose Easy 4, then IPV needs to be given separately (Separate injection, can be given on same day, but on different site). Second, Easy 4 has DTwP (whole cell DPT), while Pentaxim has DTaP (acellular or "gentle" DPT). Both DTwP and DTaP are equally effective, but chances of pain and fever are more with DTwP. Pentaxim is coslier than Easy four. Pentaxim costs Rs. 1893 per dose; Easy 4 and IPV would cost about 900 per dose (The doctor would also charge his consultation and injection fee, as applicable). The choice is yours.

Hepatitis B vaccine can be taken on the same day. If you choose DTwP, Then your daughter can be given Easy 5 rather than Easy 4 (Easy 5 is a combination of DTwP, Hib and Hepatitis B). Thus either way, your daughter needs two pricks: Pentaxim & Hepatitis B OR Easy 5 & IPV.

Your daughter has not been given pneumococcal vaccine (PCV; "pneumonia" vaccine): It is also recommended by Indian Academy of Pedictrics for routine use.

You can see the current immunization schedule at:

Please feel free to ask for any further clarification.

Best wishes,
Dr. Puneet Kumar,
Kumar Child Clinic, Dwarka,
New Delhi, India


[an error occurred while processing this directive]---------- FOLLOW-UP ----------

QUESTION: Hello Doctor!

Thanks for your reply.
As you menioned that Easy 5 can be given along with IPV to complete all the vaccination. As we given Pentaxim earlier and now Easy that OK to given in this form? Also HEP B can be given a week before 6th month completon. What's the price for Easy 5 and IPV ?

My doctor informed me about PCV and said it's's up to you if you want then you can pick this too..Cost was too high 3800..that's the reason I dont pick this vaccination. Is that really required?


ANSWER: Hi Anshul,

As I informed earlier also, you can go for Easy 5, if you so desire. Yes, Hep B vaccine's 3 rd dose can be given one week earlier. Price of Easy 5 and IPV would be around Rs. 1000 (Plus doctor's consultation and injection fee, as applicable).

PCV is not optional but recommended for routine use...Countries like Pakistan are providing it free of cost through Govt set up (and Bangladesh is introducing it in Govt set up from September 2013). In India, it is still available through private set up yet. Yes, it (Prevenar 13) costs Rs. 3801 per dose (The same vaccine by same manufacurer costs Rs. 7000 per dose in USA!)...but there is another brand: Synflorix that is less costly (Rs. 1999 per dose), but is less effective than Prevenar 13, as it covers only 10 types of the bacteria, as compared to 13 in Prevenar 13.

Best wishes,
Dr. Puneet Kumar,
Kumar Child Clinic, Dwarka,
New Delhi, India


---------- FOLLOW-UP ----------

QUESTION: Hello Sir,

Thanks for your clarification.
As I just cam to know that my doctor is on leave and would be available next week. Is it OK to delay for one week. last dose was given on 4th April.

Also want to know that easy 5 is not available in the market which other brand i can choose for the same OR if i go with pentaxim then which brand I choose for Hep B? Thanks for your advice.


Hi Anshul,

There is no problem for a week's delay. But don't delay it any further, as her vaccination is much behind the schedule. Normally, 3 doses of DPT, IPV and PCV are administered by 3.5 months (14 weeks) of age!

Your pediatrician would choose appropriate brand as per the availability. It is his/ her duty!

Best wishes,
Dr. Puneet Kumar,
Kumar Child Clinic, Dwarka,
New Delhi, India



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Dr. Puneet Kumar


I would be happy to answer general queries on prevention and treatment of ailments in newborn, infant, toddler, child or an adolescent. Needless to say, it will not be possible to answer any query that requires diagnosing, since it is not possible to examine a child online.


I have worked in various capacities (medical officer, resident, senior resident, consultant) in public as well as private sector in Pediatrics and Neonatology. Today, I have over 17 years of experience in the field.

Currently, I am running my own clinic (Kumar Child Clinic) in Dwarka, New Delhi and am attached to Lifeline Hospital, Dwarka as consultant pediatrics and neonatology. I am also developing my clinic website into a comprehensive child health/ parenting website (

(a) Chapter "National Immunization Schedule" in Frontiers of Social Pediatrics, Jaypee Publishers: 2nd edition, 2016. (b) Article, "All about Pertussis vaccines" in special issue of Indian Journal of Practical Pediatrics, July-Sept 2015 (c) Three chapters (DTP vaccines, Pneumococcal vaccines and Poliovirus vaccines) in "Textbook of Pediatrics for Post-graduates" First edition: 2015. (c) Chapter: "Alternative delivery methods of vaccines" in IAP textbook of Vaccines, First edition, 2014 (published by IAP/ Jaypee Brothers) (d) Special Article: "50 years of Immunization in India: Progress and Future" in January 2013 issue of Indian Pediatrics (e) Four chapters in "FAQ: Book on Vaccines and Immunization Practices" First edition, 2011 AND 2nd edition, 2015 published by Jaypee Brothers. (f) Three articles in special issue of Journal of Pediatric Sciences on “Controversies and Challenges in Pediatric Vaccination Today" in Sept, 2010. Co-edited the series also. (f) Regular column, “How do I treat” in Pediascene ( (g) Review article, “Role of Anti-Poliovirus Agents in Polio eradication and beyond” in Polio Pulse, April, 2008. (h) Chapter on “Acute Infectious Diarrhea” in Textbook of Infectious Diseases in Children. (An IAP Publication), 2007. 2nd edition in 2011. (i) Book-Review (IAP Pediatric Drug Formulary, 2004) in Pediascene, March 2005 ( ) (j) Case-report on Osteopetrosis. Jharkhand Journal of Pediatrics, Dec-2002.

After MBBS, I have done DNB residency in Pediatrics.

Awards and Honors
Winner of IAP practising pediatrician's quiz in 2001.

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