Hexacima (Haemophilus Influenzae Type B Polysaccharide (Polyribosylribitol Phosphate), Diphtheria Toxoid, Teta)

Hexacima is indicated for the prevention of three bacterial diseases in individuals according to immunization guidelines.

• Prevention of invasive disease caused by Haemophilus influenzae type b (Hib), including meningitis, pneumonia, and epiglottitis.
• Immunization against diphtheria, reducing the risk of severe respiratory and cardiac complications.
• Protection from tetanus, a toxin‑mediated disease that can cause muscle rigidity and spasms.
• Use as part of routine childhood vaccination programs in regions where Hib, diphtheria, or tetanus are endemic.
• Administration to travelers or adults who have not completed primary series for these antigens.

• Hexacima works by presenting conjugated polysaccharide antigens from Haemophilus influenzae type b together with diphtheria and tetanus toxoids to the immune system. The carrier protein enhances recognition by B cells, leading to T‑cell–dependent antibody production. This results in the generation of high‑affinity IgG antibodies that neutralize the Hib capsular polysaccharide and the diphtheria and tetanus toxins, providing protective immunity and establishes immunological memory for long‑term protection.

Like all vaccines, Hexacima may cause local and systemic reactions, most of which are mild and self‑limiting.

Common

• Pain, redness, or swelling at the injection site.
• Low‑grade fever occurring within 24–48 hours.
• Mild fatigue or irritability, especially in children.
• Headache or mild muscle aches.
• Mild nausea or loss of appetite.

Serious

• Severe allergic reaction (anaphylaxis) with difficulty breathing, hives, or swelling of the face.
• High fever (≥40 °C) persisting more than 24 hours.
• Neurological symptoms such as seizures or prolonged crying in infants.
• Signs of Guillain‑Barré syndrome, including muscle weakness.
• Severe local reaction with ulceration or necrosis at injection site.

Healthcare providers should assess patient history and current health status before administering Hexacima to minimize risks.

• Defer vaccination in individuals with a known severe allergy to any vaccine component.
• Postpone if the patient has a moderate or severe acute illness with fever.
• Use caution in persons with a history of seizures or neurological disorders.
• Evaluate immunocompromised patients, as response may be reduced.
• Discuss the benefits versus risks with pregnant or breastfeeding women, since safety data are limited.
• Monitor for immediate reactions for at least 15 minutes after injection.

Vaccines generally have few drug‑drug interactions, but certain conditions may affect the safety or effectiveness of Hexacima.

Avoid

• Concurrent administration with live viral vaccines (e.g., measles, mumps, rubella) in the same injection site.
• Use in individuals receiving high‑dose immunoglobulin therapy within 3 weeks, which may blunt the immune response.
• Administration during ongoing severe allergic reactions or anaphylaxis.

Use with caution

• Simultaneous receipt of other inactivated vaccines; spacing may be considered to reduce local reactogenicity.
• Patients on immunosuppressive therapy, as antibody production may be suboptimal.
• Individuals receiving antipyretics prophylactically, which could mask fever as a sign of reaction.