Diphtheria, pertussis acellular, polio, and tetanus are serious diseases caused by bacteria or virus.

Diphtheria can lead to breathing problems, paralysis, heart failure, or death.

Pertussis (whooping cough) causes severe long-lasting episodes of cough that can interfere with eating, drinking, or breathing. Pertussis can lead to pneumonia, seizures, brain damage, and death.

Polio affects the central nervous system and spinal cord, causing muscle weakness and paralysis. Polio can be fatal if it paralyzes muscles that help you breathe.

Tetanus (lockjaw) causes painful tightening of the muscles that can lead to "locking" of the jaw so the victim cannot open the mouth, swallow, or breathe. Tetanus can lead to death.

Diphtheria, pertussis, and polio are spread from person to person. Tetanus enters the body through a cut or wound.

This vaccine is used to help prevent these diseases in children who are ages 4 through 6 years (before the 7th birthday) who have received prior vaccination with a DTaP and IPV series.

This vaccine helps your child's body develop immunity to these diseases, but will not treat an active infection the child already has.

Like any vaccine, the diphtheria, pertussis acellular, polio, and tetanus vaccine may not provide protection from disease in every person.

Becoming infected with diphtheria, pertussis, polio, or tetanus is much more dangerous to your child's health than receiving this vaccine.

This vaccine is given as an injection (shot) into a muscle.

This vaccine is given as the 5th dose in a series of DTaP immunizations and the 4th dose in a series of IPV immunizations. The shot is usually given to a child who is at least 4 years old or has not yet reached his or her 7th birthday.

Your child's booster schedule may be different from these guidelines. Follow your child doctor's instructions or the schedule recommended by your local health department.

Your child should not receive this vaccine if he or she has:

• a history of life-threatening allergic reaction to a vaccine containing diphtheria, pertussis, polio, or tetanus;

• a history of decreased consciousness, seizures, or coma within 7 days after receiving a pertussis vaccine; or

• a progressive or untreated nervous system problem or brain disorder (such as infantile spasms or uncontrolled epilepsy).

Your child may not be able to receive this vaccine if he or she has ever received a pertussis vaccine that caused:

• within 48 hours after the vaccine--a very high fever (over 104 degrees), excessive crying for 3 hours or longer, fainting or going into shock; or

• within 3 days after the vaccine--a seizure.

Tell the vaccination provider if your child has ever had:

• seizures;

• chemotherapy or radiation;

• a weak immune system (caused by disease or by using certain medicine);

• Guillain-Barré syndrome within 6 weeks after receiving a tetanus vaccine; or

• an allergy to latex rubber.

Your child can still receive a vaccine if he or she has a minor cold. In the case of a more severe illness with a fever or any type of infection, wait until the child gets better before receiving this vaccine.

Contact your child's doctor if your child will miss a booster dose or if he or she will get behind schedule. The next dose should be given as soon as possible. There is no need to start over.

Be sure your child receives all recommended doses in the DTaP and IPV series, or the child may not be fully protected against disease.

An overdose of this vaccine is unlikely to occur.

Follow the vaccination provider's instructions about any restrictions on food, beverages, or activity.

Get emergency medical help if your child has signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Your child should not receive a booster vaccine if he or she had a life threatening allergic reaction after the first shot. Keep track of all side effects your child has. If the child receives a booster dose, tell the vaccination provider if the previous shot caused any side effects.

Becoming infected with diphtheria, pertussis, polio, or tetanus is much more dangerous to your child's health than receiving this vaccine. However, like any medicine, this vaccine can cause side effects but the risk of serious side effects is low.

Call your child's doctor at once if the child has:

• fussiness, crying for an hour or longer;

• very high fever; or

• a light-headed feeling, like you might pass out;

You may be able to treat fever or pain with an over-the-counter pain reliever such as acetaminophen (Tylenol) or ibuprofen (Motrin, Advil, and others). Follow the label directions or the vaccination provider's instructions.

It is especially important to prevent fever from occurring if you have a seizure disorder such as epilepsy.

Common side effects of Quadracel may include:

• drowsiness;

• headache, muscle pain;

• loss of appetite; or

• redness, pain, or swelling where the shot was given.

This is not a complete list of side effects and others may occur. Call your child's doctor for medical advice about side effects. You may report vaccine side effects to the US Department of Health and Human Services at 1-800-822-7967.

Before receiving this vaccine, tell the vaccination provider about all other vaccines your child has received.

Also, tell the vaccination provider if your child has recently received drugs or treatments that can weaken the immune system, including:

• steroid medicine;

• cancer treatments;

• medicine to treat psoriasis, rheumatoid arthritis, or other autoimmune disorders; or

• medicine to treat or prevent organ transplant rejection.

If your child is using any of these medications, he or she may not be able to receive the vaccine, or may need to wait until the other treatments are finished.

This list is not complete. Other drugs may affect this vaccine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.