The combination diphtheria-pertussis-tetanus (DPT) vaccine is usually given at the same time as OPV.
3.1 Prepare the DPT vaccine
1) Shake the vial so that the sediment at the bottom mixes completely with the liquid. If the toxoid is not well mixed the correct dose cannot be given.
2) If you suspect that the toxoid has been frozen and thawed, check for damage by using the shake test (see Module 3).
3) Remove the centre of the metal cap on the vial with a metal file.
3.2 Position the child
Ask the parent to remove any clothing from the child's right or left leg so that the thigh is bare.
The child should sit on the parent's lap as indicated below:
• The parent's left arm should be around the child, supporting her or his head and holding the outside arm.
• The child's inside arm should be tucked around the parent's body.
• The parent's right hand should hold the child's legs firmly.
Inject DPT vaccine into the thigh, NEVER into the buttock.
Figure 8-G: Holding child for DPT immunization
Injections into the buttock the buttock should not be used as an immunization site for children or women because there is a risk of injury to the sciatic nerve which can cause paralysis.
3.3 Inject the DPT vaccine
You need a sterile 1.0 ml syringe and a sterile 25 mm, 22 gauge reusable needle or a 25 mm, 23 gauge single-use needle.
1) Put your finger and thumb on the OUTER part of the middle of the child's thigh.
2) Stretch the skin flat between your finger and thumb.
3) Quickly push the needle straight down through the skin between your fingers. Go deep into the muscle.
Figure 8-H: Needle position for DPT
4) Press the plunger with your thumb to inject the vaccine.
5) Withdraw the needle and press the site with cotton wool.
Remember about DPT injections:
• Give 0.5 ml on three occasions:
at 6 weeks;
at 10 weeks;
at 14 weeks.
• Inject DPT into the child's thigh.
• Do not inject DPT (or any other vaccine) into the buttock.
• Do not freeze DPT.