QUADRACEL

Manufacturer
Sanofi Pasteur Inc. | Sanofi Pasteur Limited
Effective date
2023-08-21
Label type
VACCINE LABEL
Version
10
Source
legacy-cache
Hydrated at
2026-08-01 21:26:59

Label at a glance#

ProductQUADRACEL
Active ingredientCORYNEBACTERIUM DIPHTHERIAE TOXOID ANTIGEN (FORMALDEHYDE INACTIVATED), CLOSTRIDIUM TETANI TOXOID ANTIGEN (FORMALDEHYDE INACTIVATED), BORDETELLA PERTUSSIS TOXOID ANTIGEN (GLUTARALDEHYDE INACTIVATED), BORDETELLA PERTUSSIS FILAMENTOUS HEMAGGLUTININ ANTIGEN (FORMALDEHYDE INACTIVATED), BORDETELLA PERTUSSIS PERTACTIN ANTIGEN, BORDETELLA PERTUSSIS FIMBRIAE 2/3 ANTIGEN, POLIOVIRUS TYPE 1 ANTIGEN (FORMALDEHYDE INACTIVATED), POLIOVIRUS TYPE 2 ANTIGEN (FORMALDEHYDE INACTIVATED), POLIOVIRUS TYPE 3 ANTIGEN (FORMALDEHYDE INACTIVATED)
Label structure18 sections

Indications and uses

Quadracel ® is a vaccine indicated for active immunization against diphtheria, tetanus, pertussis and poliomyelitis. A single dose of Quadracel is approved for use as a fifth dose in the diphtheria, tetanus, pertussis (DTaP) vaccination series, and as a fourth or fifth dose in the inactivated poliovirus (IPV) vaccination series in children 4 through 6 years of age whose previous DTaP vaccine doses have been with P...

Dosage and administration

For intramuscular injection only. Just before use, shake the vial well, until a uniform, white, cloudy suspension results. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. If either of these conditions exist, the product should not be administered. Withdraw and administer a 0.5 mL dose of Quadracel vaccin...

Storage and handling

The vial stopper for this product is not made with natural latex rubber. Quadracel is supplied in a single-dose vial (NDC No. 49281-562-58) in packages of 10 vials (NDC No. 49281-562-10). Quadracel should be stored at 2° to 8°C (35° to 46°F). Do not freeze . Product which has been exposed to freezing should not be used. Do not use after expiration date shown on the label.

Label contents#

Full prescribing information#

1 INDICATIONS AND USAGE

INDICATIONS & USAGE SECTION

Quadracel® is a vaccine indicated for active immunization against diphtheria, tetanus, pertussis and poliomyelitis. A single dose of Quadracel is approved for use as a fifth dose in the diphtheria, tetanus, pertussis (DTaP) vaccination series, and as a fourth or fifth dose in the inactivated poliovirus (IPV) vaccination series in children 4 through 6 years of age whose previous DTaP vaccine doses have been with Pentacel® [Diphtheria and Tetanus Toxoids and Acellular Pertussis Vaccine Adsorbed, Inactivated Poliovirus and Haemophilus b conjugate (Tetanus Toxoid Conjugate) Vaccine], DAPTACEL® (Diphtheria and Tetanus Toxoids and Acellular Pertussis Vaccine Adsorbed) and/or VAXELIS (Diphtheria and Tetanus Toxoids and Acellular Pertussis, Inactivated Poliovirus, Haemophilus b Conjugate and Hepatitis B Vaccine).

2 DOSAGE AND ADMINISTRATION

DOSAGE & ADMINISTRATION SECTION

For intramuscular injection only.

Just before use, shake the vial well, until a uniform, white, cloudy suspension results. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. If either of these conditions exist, the product should not be administered.

Withdraw and administer a 0.5 mL dose of Quadracel vaccine intramuscularly into the deltoid muscle of the upper arm. Discard unused portion.

Quadracel should not be combined through reconstitution or mixed with any other vaccine.

3 DOSAGE FORMS AND STRENGTHS

DOSAGE FORMS & STRENGTHS SECTION

Quadracel is a suspension for injection in 0.5 mL single-dose vials.

4 CONTRAINDICATIONS

CONTRAINDICATIONS SECTION

4.1 Hypersensitivity

SPL UNCLASSIFIED SECTION

Severe allergic reaction (e.g., anaphylaxis) to any ingredient of Quadracel [see Description (11)] or following any diphtheria toxoid, tetanus toxoid, pertussis-containing vaccine, or inactivated poliovirus vaccine, is a contraindication to administration of Quadracel.

4.2 Encephalopathy

SPL UNCLASSIFIED SECTION

Encephalopathy (e.g., coma, decreased level of consciousness, prolonged seizures) within 7 days of a previous dose of a pertussis-containing vaccine that is not attributable to another identifiable cause is a contraindication to administration of any pertussis-containing vaccine, including Quadracel.

4.3 Progressive Neurologic Disorder

SPL UNCLASSIFIED SECTION

Progressive neurologic disorder, including infantile spasms, uncontrolled epilepsy, or progressive encephalopathy is a contraindication to administration of any pertussis-containing vaccine including Quadracel. Pertussis vaccine should not be administered to individuals with such conditions until a treatment regimen has been established and the condition has stabilized.

5 WARNINGS AND PRECAUTIONS

WARNINGS AND PRECAUTIONS SECTION

5.1 Management of Acute Allergic Reactions

SPL UNCLASSIFIED SECTION

Epinephrine hydrochloride solution (1:1,000) and other appropriate agents and equipment must be available for immediate use in case an anaphylactic or acute hypersensitivity reaction occurs.

5.2 Adverse Reactions Following Prior Pertussis Vaccination

SPL UNCLASSIFIED SECTION

If any of the following events have occurred within the specified period after administration of a pertussis vaccine, the decision to administer Quadracel should be based on careful consideration of benefits and risks.

  • Temperature of ≥40.5°C (≥105°F) within 48 hours, not attributable to another identifiable cause.
  • Collapse or shock-like state (hypotonic-hyporesponsive episode [HHE]) within 48 hours.
  • Persistent, inconsolable crying lasting ≥3 hours within 48 hours.
  • Seizures with or without fever within 3 days.

5.3 Guillain-Barré Syndrome

SPL UNCLASSIFIED SECTION

If Guillain-Barré syndrome occurred within 6 weeks of receipt of a prior vaccine containing tetanus toxoid, the decision to give any vaccine containing tetanus toxoid, including Quadracel, should be based on careful consideration of the potential benefits and possible risks.

5.4 Limitations of Vaccine Effectiveness

SPL UNCLASSIFIED SECTION

Vaccination with Quadracel may not protect all individuals.

5.5 Altered Immunocompetence

SPL UNCLASSIFIED SECTION

If Quadracel is administered to immunocompromised persons, including persons receiving immunosuppressive therapy, the expected immune response may not be obtained. [See Drug Interactions (7.2).]

5.6 Syncope

SPL UNCLASSIFIED SECTION

Syncope (fainting) may occur in association with administration of injectable vaccines including Quadracel. Procedures should be in place to avoid injury from fainting.

6 ADVERSE REACTIONS

ADVERSE REACTIONS SECTION

In a clinical study, the most common solicited injection site reactions were pain (>75%), increase in arm circumference (>65%), erythema (>55%), and swelling (>40%). Common solicited systemic reactions were myalgia (>50%), malaise (>35%), and headache (>15%).

6.1 Clinical Trials Experience

SPL UNCLASSIFIED SECTION

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a vaccine cannot be directly compared to rates in the clinical trials of another vaccine and may not reflect the rates observed in practice. The adverse reaction information from clinical trials does, however, provide a basis for identifying the adverse events that appear to be related to vaccine use and for approximating rates of those events.

In a randomized, controlled, multicenter study conducted in the US and Puerto Rico (Study M5I02; ClinicalTrials.gov Identifier: NCT01346293), 3,372 children, 4 to 6 years of age, who had received 4 doses of DAPTACEL and/or Pentacel vaccine(s) received Quadracel, or DAPTACEL + IPOL (Poliovirus Vaccine Inactivated) vaccines administered concomitantly but at separate sites. Subjects also received Measles, Mumps, and Rubella Virus Vaccine Live (MMR) (Merck & Co., Inc.) and Varicella Virus Vaccine Live (Varicella vaccine) (Merck & Co., Inc.) administered concomitantly at separate sites. Safety was evaluated in 2,733 subjects who received Quadracel and 621 subjects who received DAPTACEL + IPOL vaccines.

Among these subjects, 51.5% were male, 48.5% were female, 75.7% were Caucasian, 8.6% were Black, 7.9% were Hispanic, 0.9% were Asian, and 7.8% were of other racial/ethnic groups. The mean age for both groups was 4.4 years and the ratio of male to female subjects and ethnicity were balanced between both groups.

Solicited injection site reactions and systemic reactions were collected daily for 7 days following vaccination, via diary cards. Participants were monitored for unsolicited adverse events for 28 days and serious adverse events (SAEs) for 6 months after vaccination.

SPL UNCLASSIFIED SECTION

Solicited Adverse Reactions

The incidence and severity of solicited injection site and systemic adverse reactions that occurred within 7 days after vaccination in each study group are shown in Table 1.

Table 1: Percentage of Children 4 through 6 years of Age with Solicited Adverse Reactions by Intensity Within 7 Days of Vaccination with Quadracel or Concomitant but Separate DAPTACEL and IPOL vaccines Co-Administered with MMR and Varicella Vaccines*
Quadracel
(N† = 2,500-2,689)
DAPTACEL + IPOL
(N† = 598-603)
  Injection Site ReactionsQuadracel siteDAPTACEL or IPOL site
Pain‡, Any77.476.5
Pain‡, Grade 156.454.9
Pain‡, Grade 219.018.6
Pain‡, Grade 32.03.0
Change in limb circumference§, Any 68.165.1
Change in limb circumference§, Grade 159.858.6
Change in limb circumference§, Grade 28.26.5
Change in limb circumference§, Grade 30.20.0
Erythema, Any59.153.4
Erythema, >0 to <25 mm31.631.8
Erythema, ≥25 to <50 mm9.59.6
Erythema, ≥50 mm18.011.9
Swelling, Any40.236.4
Swelling, >0 to <25 mm23.523.1
Swelling, ≥25 to <50 mm8.16.1
Swelling, ≥50 mm8.67.1
Extensive limb swelling, Any1.51.3
Systemic Reactions
Myalgia#, Any 53.852.6
Myalgia#, Grade 136.033.5
Myalgia#, Grade 215.816.3
Myalgia#, Grade 31.92.8
Malaise#, Any35.033.2
Malaise#, Grade 121.718.7
Malaise#, Grade 210.611.1
Malaise#, Grade 32.63.3
Headache#, Any15.616.6
Headache#, Grade 111.911.9
Headache#, Grade 23.14.0
Headache#, Grade 30.60.7
Fever, Any 6.06.9
Fever ≥38.0°C to ≤38.4°C2.63.0
Fever, ≥38.5°C to ≤38.9°C2.11.8
Fever, ≥39.0°C1.32.0

* ClinicalTrials.gov Identifier: NCT01346293.

† N = The number of subjects with available data.

‡ Grade 1: Easily tolerated, Grade 2: Sufficiently discomforting to interfere with normal behavior or activities, Grade 3: Incapacitating, unable to perform usual activities.

§ Grade 1: >0 to <25 mm increase over pre-vaccination measurement, Grade 2: ≥25 to ≤50 mm increase over pre-vaccination measurement, Grade 3: >50 mm increase over pre-vaccination measurement.

Swelling of the injected limb including the adjacent joint (i.e., elbow and/or shoulder) as compared to baseline.

# Grade 1: No interference with activity, Grade 2: Some interference with activity, Grade 3: Significant; prevents daily activity.

SPL UNCLASSIFIED SECTION

Serious Adverse Events

In Study M5I02, within 28 days following vaccination with Quadracel, or DAPTACEL + IPOL vaccines, and concomitant MMR and varicella vaccines, 0.1% of subjects (3/2,733) in the Quadracel group experienced a serious adverse event. During the same time period, 0.2% subjects (1/621) in the DAPTACEL + IPOL group experienced a SAE. Within the 6-month follow-up period after vaccination, SAEs were reported in 0.8% of subjects (21/2,733) who received Quadracel and 0.5% of subjects (3/621) who received DAPTACEL + IPOL vaccines, none of which were assessed as related to vaccination.

6.2 Postmarketing Experience

SPL UNCLASSIFIED SECTION

The following adverse events have been spontaneously reported, during the post-marketing use of Quadracel outside the US, in infants and children from 2 months through 6 years of age. Because these events are reported voluntarily from a population of uncertain size, it is not possible to estimate their frequency reliably or establish a causal relationship to vaccine exposure. This list includes adverse events based on one or more of the following factors: severity, frequency of reporting, or strength of evidence for a causal relationship to Quadracel.

  • Immune system disorders
    Anaphylactic reaction, hypersensitivity and allergic reactions (such as rash, urticaria, dyspnea)
  • Psychiatric disorders
    Screaming
  • Nervous system disorders
    Somnolence, convulsion, febrile convulsion, HHE, hypotonia
  • Cardiac disorders
    Cyanosis
  • Vascular disorders
    Pallor
  • General disorders and administration site conditions
    Listlessness
    Injection site reactions (including inflammation, mass, sterile abscess, and edema)
    Large injection site reactions (>50 mm), including limb swelling which may extend from the injection site beyond one or both joints
  • Infections and Infestations
    Injection site cellulitis, injection site abscess

7 DRUG INTERACTIONS

DRUG INTERACTIONS SECTION

7.1 Concomitant Administration with Other Vaccines

SPL UNCLASSIFIED SECTION

In the US clinical trial, Study M5I02, Quadracel was administered concomitantly with one or more of the following US-licensed vaccines: MMR vaccine and varicella vaccine. [See Adverse Reactions (6.1).]

When Quadracel is given at the same time as another injectable vaccine(s), the vaccines should be administered with different syringes and at different injection sites.

7.2 Immunosuppressive Treatments

SPL UNCLASSIFIED SECTION

Immunosuppressive therapies, including irradiation, antimetabolites, alkylating agents, cytotoxic drugs and corticosteroids (used in greater than physiologic doses), may reduce the immune response to Quadracel. [See Warnings and Precautions (5.5).]

8 USE IN SPECIFIC POPULATIONS

USE IN SPECIFIC POPULATIONS SECTION

8.4 Pediatric Use

PEDIATRIC USE SECTION

The safety and effectiveness of Quadracel has not been established in children less than 4 years of age or children 7 through 16 years of age and is not approved for use in these age groups.

11 DESCRIPTION

DESCRIPTION SECTION

Quadracel (Diphtheria and Tetanus Toxoids and Acellular Pertussis Adsorbed and Inactivated Poliovirus Vaccine) is a sterile suspension for intramuscular injection.

Each 0.5 mL dose is formulated to contain 15 Lf diphtheria toxoid, 5 Lf tetanus toxoid, acellular pertussis antigens [20 mcg detoxified pertussis toxin (PT), 20 mcg filamentous hemagglutinin (FHA), 3 mcg pertactin (PRN), 5 mcg fimbriae types 2 and 3 (FIM)], and inactivated polioviruses [40 D-antigen units (DU) Type 1 (Mahoney), 8 DU Type 2 (MEF-1), 32 DU Type 3 (Saukett)].

Corynebacterium diphtheriae is grown in modified Mueller's growth medium. (1) After purification by ammonium sulfate fractionation, the diphtheria toxin is detoxified with formaldehyde and diafiltered.

Clostridium tetani is grown in modified Mueller-Miller casamino acid medium without beef heart infusion. (2) Tetanus toxin is detoxified with formaldehyde and purified by ammonium sulfate fractionation and diafiltration. Diphtheria and tetanus toxoids are individually adsorbed onto aluminum phosphate.

The acellular pertussis vaccine antigens are produced from Bordetella pertussis cultures grown in Stainer-Scholte medium (3) modified by the addition of casamino acids and dimethyl-beta-cyclodextrin. PT, FHA and PRN are isolated separately from the supernatant culture medium. FIM are extracted and copurified from the bacterial cells. The pertussis antigens are purified by sequential filtration, salt-precipitation, ultrafiltration and chromatography. PT is detoxified with glutaraldehyde. FHA is treated with formaldehyde and the residual aldehydes are removed by ultrafiltration. The individual antigens are adsorbed separately onto aluminum phosphate.

Poliovirus Type 1, Type 2 and Type 3 are each grown in separate cultures of MRC-5 cells, a line of normal human diploid cells, by the microcarrier method. (4) (5) The cells are grown in CMRL (Connaught Medical Research Laboratories) 1969 medium, supplemented with calf serum. For viral growth, the culture medium is replaced by Medium 199, without calf serum. After clarification and filtration, the viral suspensions are concentrated by ultrafiltration, and purified by liquid chromatography steps. The monovalent viral suspensions are inactivated with formaldehyde. Monovalent concentrates of each inactivated poliovirus are combined to produce a trivalent poliovirus concentrate.

The adsorbed diphtheria, tetanus and acellular pertussis antigens are combined with aluminum phosphate, 2-phenoxyethanol (not as a preservative) and water for injection, into an intermediate concentrate. The trivalent poliovirus concentrate is added and the vaccine is diluted to its final concentration.

Each 0.5 mL dose contains 1.5 mg aluminum phosphate (0.33 mg aluminum) as the adjuvant, polysorbate 80 (approximately 10 ppm by calculation), <2 mcg residual formaldehyde, <50 ng residual glutaraldehyde, ≤50 ng residual bovine serum albumin, 3.3 mg (0.6% v/v) 2-phenoxyethanol (not as a preservative), <4 pg of neomycin and <4 pg polymyxin B sulfate.

Quadracel does not contain a preservative.

Both diphtheria and tetanus toxoids induce at least 2 neutralizing units per mL in the guinea pig potency test. The potency of the acellular pertussis antigens is evaluated by the antibody response of immunized mice to detoxified PT, FHA, PRN and FIM as measured by enzyme-linked immunosorbent assay (ELISA). The potency of the inactivated poliovirus antigens is determined by measuring antibody-mediated neutralization of poliovirus in sera from immunized rats.

12 CLINICAL PHARMACOLOGY

CLINICAL PHARMACOLOGY SECTION

12.1 Mechanism of Action

MECHANISM OF ACTION SECTION

SPL UNCLASSIFIED SECTION

Diphtheria

Diphtheria is an acute toxin-mediated disease caused by toxigenic strains of C. diphtheriae. Protection against disease is due to the development of neutralizing antibodies to diphtheria toxin. A serum diphtheria antitoxin level of 0.01 IU/mL is the lowest level giving some degree of protection. Antitoxin levels of at least 0.1 IU/mL are generally regarded as protective. (6) Levels of 1.0 IU/mL have been associated with long-term protection. (7)

SPL UNCLASSIFIED SECTION

Tetanus

Tetanus is an acute disease caused by an extremely potent neurotoxin produced by C. tetani. Protection against disease is due to the development of neutralizing antibodies to tetanus toxin. A serum tetanus antitoxin level of at least 0.01 IU/mL, measured by neutralization assay, is considered the minimum protective level. (6) (8). A tetanus antitoxoid level ≥0.1 IU/mL as measured by the ELISA used in clinical studies of Quadracel is considered protective.

SPL UNCLASSIFIED SECTION

Pertussis

Pertussis (whooping cough) is a respiratory disease caused by B. pertussis. This Gram-negative coccobacillus produces a variety of biologically active components, though their role in either the pathogenesis of, or immunity to, pertussis has not been clearly defined.

There is no well-established serological correlate of protection for pertussis. Because DAPTACEL contains the same pertussis antigens manufactured by the same process as those in Quadracel, the effectiveness of Quadracel against pertussis was based on a comparison of pertussis immune responses following Quadracel to those following DAPTACEL (Diphtheria and Tetanus Toxoids and Acellular Pertussis Vaccine Adsorbed). [See Clinical Studies (14)]. The efficacy of the pertussis component of DAPTACEL was determined in clinical trials of DAPTACEL administered to infants (see DAPTACEL prescribing information). Quadracel contains twice as much detoxified PT and four times as much FHA as DAPTACEL. Quadracel contains the same quantity of the same pertussis antigens manufactured by the same process as those in Pentacel and VAXELIS.

SPL UNCLASSIFIED SECTION

Poliomyelitis

Polioviruses, of which there are three serotypes (Types 1, 2, and 3), are enteroviruses. The presence of poliovirus type-specific neutralizing antibodies has been correlated with protection against poliomyelitis. (9)

13 NONCLINICAL TOXICOLOGY

NONCLINICAL TOXICOLOGY SECTION

13.1 Carcinogenesis, Mutagenesis, Impairment of Fertility

CARCINOGENESIS & MUTAGENESIS & IMPAIRMENT OF FERTILITY SECTION

Quadracel has not been evaluated for carcinogenic or mutagenic potential or impairment of fertility.

14 CLINICAL STUDIES

CLINICAL STUDIES SECTION

14.1 Immunogenicity

SPL UNCLASSIFIED SECTION

In Study M5I02, children 4 through 6 years of age received Quadracel or DAPTACEL + IPOL as the fifth dose in the diphtheria, tetanus, and pertussis vaccination series and the fourth or fifth dose in the inactivated poliovirus vaccination series. Subjects also received their second dose of MMR and Varicella vaccines, concomitantly. The immunogenicity subset comprised 263 subjects in the Quadracel group and 253 subjects in the DAPTACEL + IPOL vaccines group. [See study description in Adverse Reactions (6.1)].

Antibody levels to diphtheria, tetanus, pertussis (PT, FHA, PRN and FIM) and poliovirus antigens were measured in sera obtained immediately prior to vaccination and 28 days after vaccination. The co-primary endpoints were booster response rates and antibody geometric mean concentrations/titers (GMCs/GMTs) to diphtheria, tetanus, pertussis and poliovirus antigens elicited after vaccination. Booster response rates and antibody GMCs/GMTs following Quadracel vaccination were compared to those after DAPTACEL + IPOL vaccination.

Quadracel was non-inferior to DAPTACEL + IPOL vaccines administered concomitantly at separate sites, as demonstrated by comparison of the post-vaccination antibody booster response rates and GMCs/GMTs to diphtheria and tetanus (Table 2), to all pertussis antigens (Table 3) and to poliovirus 1, 2 and 3 (Table 4).

Table 2: Booster Response Rates, Pre- and Post-Vaccination Seroprotection Rates and Post-Vaccination Antibody Levels to Diphtheria and Tetanus Antigens Following Quadracel or Concomitant but Separate DAPTACEL and IPOL Vaccines Co-Administered with MMR and Varicella Vaccines*
Quadracel
(N† = 253-262)
DAPTACEL + IPOL
(N† = 248-253)
Anti-Diphtheria
% Booster Response‡ 97.3§ 99.2
Pre-vaccination % ≥0.1 IU/mL 90.783.1
Post-vaccination % ≥0.1 IU/mL 100.099.6
Post-vaccination % ≥1.0 IU/mL 99.699.6
Post-vaccination GMC (IU/mL)18.6# 15.5
Anti-Tetanus
% Booster Response‡ 84.2§ 84.3
Pre-vaccination % ≥0.1 IU/mL 91.789.1
Post-vaccination % ≥0.1 IU/mL 100.099.2
Post-vaccination % ≥1.0 IU/mL 98.996.8
Post-vaccination GMC (IU/mL)6.4# 5.5

* ClinicalTrials.gov Identifier: NCT01346293.

† N = The number of subjects with available data.

‡ Booster response: In subjects with pre-vaccination antibody concentrations <0.1 IU/mL, a post-vaccination level ≥0.4 IU/mL; in subjects with pre-vaccination antibody concentrations ≥0.1 IU/mL but <2.0 IU/mL, a 4-fold rise in post-vaccination level; in subjects with pre-vaccination antibody level ≥2.0 IU/mL, a 2-fold rise in post-vaccination level.

§ Quadracel was non-inferior to DAPTACEL + IPOL based on the post-vaccination booster response rates for diphtheria and tetanus (lower limits of the 2-sided 95% CIs of the difference [Quadracel minus DAPTACEL + IPOL] were >-10%).

Seroprotection: anti-diphtheria and anti-tetanus antibody concentrations ≥0.1 IU/mL and ≥1.0 IU/mL.

# Quadracel was non-inferior to DAPTACEL + IPOL based on the post-vaccination GMCs for diphtheria and tetanus (lower limits of the 2-sided 95% CIs of the ratio [Quadracel / DAPTACEL + IPOL] were >2/3).

Table 3: Booster Response Rates and Post-vaccination Antibody Levels to Pertussis Antigens Following Quadracel or Concomitant but Separate DAPTACEL and IPOL Vaccines Co-Administered with MMR and Varicella Vaccines*
Quadracel
(N† = 250-255)
DAPTACEL + IPOL
(N† = 247-249)
Anti-PT
% Booster Response‡ 95.2§ 89.9
Post-vaccination GMC (EU/mL)120.7 61.3
Anti-FHA
% Booster Response‡ 94.9§ 87.5
Post-vaccination GMC (EU/mL)123.5 79.0
Anti-PRN
% Booster Response‡ 96.9§ 93.1
Post-vaccination GMC (EU/mL)282.6 187.5
Anti-FIM
% Booster Response‡ 97.2§ 92.4
Post-vaccination GMC (EU/mL)505.8 378.9

* ClinicalTrials.gov Identifier: NCT01346293.

† N = The number of subjects with available data.

‡ Booster response: In subjects with pre-vaccination antibody concentrations <LLOQ, a post-vaccination level ≥4×LLOQ; in subjects with pre-vaccination antibody concentrations ≥LLOQ but <4×LLOQ, a 4-fold rise in post-vaccination level; in subjects with pre-vaccination antibody level ≥4×LLOQ, a 2-fold rise in post-vaccination level.

§ Quadracel was non-inferior to DAPTACEL + IPOL based on the post-vaccination booster response rates for all pertussis antigens (lower limits of the 2-sided 95% CIs of the difference [Quadracel minus DAPTACEL + IPOL] were > -10%).

Quadracel was non-inferior to DAPTACEL + IPOL based on the post-vaccination GMCs for all pertussis antigens (lower limits of the 2-sided 95% CIs of the ratio [DTaP-IPV / DAPTACEL + IPOL] were >2/3).

Table 4: Booster Response Rates, Pre- and Post-Vaccination Seroprotection Rates and Post-vaccination Antibody Levels to Poliovirus Antigens Following Quadracel or Concomitant but Separate DAPTACEL and IPOL Vaccines Co-Administered with MMR and Varicella Vaccines*
Quadracel
(N† = 247-258)
DAPTACEL + IPOL
(N† = 248-253)
Anti-Poliovirus 1
% Booster Response‡ 85.9§ 82.3
Pre-vaccination % ≥1:8 dilution98.498.8
Post-vaccination % ≥1:8 dilution100.099.6
Post-vaccination GMT3,477 2,731
Anti-Poliovirus 2
% Booster Response‡ 78.3§ 79.0
Pre-vaccination % ≥1:8 dilution99.699.6
Post-vaccination % ≥1:8 dilution100.0100.0
Post-vaccination GMT3,491 3,894
Anti-Poliovirus 3
% Booster Response‡ 85.0§ 84.7
Pre-vaccination % ≥1:8 dilution96.893.1
Post-vaccination % ≥1:8 dilution100.0100.0
Post-vaccination GMT4,591 3,419

* ClinicalTrials.gov Identifier: NCT01346293.

† N = The number of subjects with available data.

‡ Booster response: In subjects with pre-vaccination antibody concentrations <1:8 dilution, post-vaccination levels ≥1:8 dil; in subjects with pre-vaccination antibody concentrations ≥1:8 dilution, a 4-fold rise in post-vaccination antibody levels.

§ Quadracel was non-inferior to DAPTACEL + IPOL based on the post-vaccination booster response rates for polio types 1, 2 and 3 (lower limits of the 2-sided 95% CIs of the difference [Quadracel minus DAPTACEL + IPOL] were > -10%).

Quadracel was non-inferior to DAPTACEL + IPOL based on the post-vaccination GMTs for polio types 1, 2 and 3 (lower limits of the 2-sided 95% CIs of the ratio [Quadracel / DAPTACEL + IPOL] were >2/3).

15 REFERENCES

REFERENCES SECTION

  • Stainer DW. Production of diphtheria toxin. In: Manclark CR, editor. Proceedings of an informal consultation on the World Health Organization requirements for diphtheria, tetanus, pertussis and combined vaccines. United States Public Health Service, Bethesda, MD. DHHS 91-1174. 1991:7-11.
  • Mueller JH, Miller PA. Variable factors influencing the production of tetanus toxin. J Bacteriol 1954;67(3):271-7.
  • Stainer DW, Scholte MJ. A simple chemically defined medium for the production of phase I Bordetella pertussis. J Gen Microbiol 1970;63:211-20.
  • van Wezel AL, et al. Inactivated poliovirus vaccine: current production methods and new developments. Rev Infect Dis 1984;6 (Suppl 2):S335-40.
  • Montagnon BJ et al. Industrial scale production of inactivated poliovirus vaccine prepared by culture of vero cells on microcarrier. Rev Infect Dis 1984;6 (Suppl 2):S341-4.
  • Department of Health and Human Services, Food and Drug Administration. Biological products; bacterial vaccines and toxoids; implementation of efficacy review; proposed rule. Federal Register 1985;50(240):51002-117.
  • Tiwari TSP, Wharton M. Diphtheria toxoid. In: Plotkin SA, Orenstein WA, and Offit PA, editors. Vaccines. 6th ed. Philadelphia, PA: WB Saunders; 2012:153-66.
  • Roper M, Wassilak SGF, Tiwari TSP, Orenstein WA. Tetanus toxoid. In: Plotkin SA, Orenstein WA, and Offit PA, editors. Vaccines. 6th ed. Philadelphia, PA: WB Saunders; 2012:746-72.
  • Sutter RW, et al. Defining surrogate serologic tests with respect to predicting protective vaccine efficacy: Poliovirus vaccination. In: Williams JC, et al. eds. Combined vaccines and simultaneous administration. Current issues and perspectives. New York, NY: The New York Academy of Sciences. 1995:289-99.

16 HOW SUPPLIED/STORAGE AND HANDLING

HOW SUPPLIED SECTION

16.1 How Supplied

SPL UNCLASSIFIED SECTION

The vial stopper for this product is not made with natural latex rubber.

Quadracel is supplied in a single-dose vial (NDC No. 49281-562-58) in packages of 10 vials (NDC No. 49281-562-10).

16.2 Storage and Handling

STORAGE AND HANDLING SECTION

Quadracel should be stored at 2° to 8°C (35° to 46°F). Do not freeze. Product which has been exposed to freezing should not be used. Do not use after expiration date shown on the label.

17 PATIENT COUNSELING INFORMATION

INFORMATION FOR PATIENTS SECTION

Inform the parent or guardian of the following:

  • The potential benefits and risks of immunization with Quadracel.
  • The common adverse reactions that have occurred following administration of Quadracel or other vaccines containing similar components.
  • Other adverse reactions can occur. Call healthcare provider with any adverse reactions of concern.

Provide the Vaccine Information Statements (VIS), which are required by the National Childhood Vaccine Injury Act of 1986.

SPL UNCLASSIFIED SECTION

Manufactured by:
Sanofi Pasteur Limited
Toronto Ontario Canada

Distributed by:
Sanofi Pasteur Inc.
Swiftwater PA 18370 USA

Quadracel® is a registered trademark of Sanofi, its affiliates and subsidiaries.

R7-0823 USA

PRINCIPAL DISPLAY PANEL - 0.5 mL Vial Label

PACKAGE LABEL.PRINCIPAL DISPLAY PANEL

DTaP-IPV
4 yrs - 6 yrs

NDC 49281-562-58
Diphtheria and Tetanus
Toxoids and Acellular
Pertussis Adsorbed and
Inactivated Poliovirus
Vaccine

Quadracel®

Rx only
IM only

Single-dose (0.5 mL)
Sanofi Pasteur Limited

PRINCIPAL DISPLAY PANEL - 0.5 mL Vial Label
PRINCIPAL DISPLAY PANEL - 0.5 mL Vial Label

PRINCIPAL DISPLAY PANEL - 0.5 mL Vial Carton

PACKAGE LABEL.PRINCIPAL DISPLAY PANEL

NDC 49281-562-10
DTaP-IPV

Diphtheria and Tetanus
Toxoids and Acellular Pertussis
Adsorbed and Inactivated
Poliovirus Vaccine

10 single-dose vials
0.5 mL

Rx only

Quadracel®

For children 4 years
through 6 years of age

SANOFI PASTEUR

PRINCIPAL DISPLAY PANEL - 0.5 mL Vial Carton
PRINCIPAL DISPLAY PANEL - 0.5 mL Vial Carton

DailyMed Billing Units#

Package NDC, Billing unit, Product NDC table
Package NDCBilling unitProduct NDCDailyMed indexing SPLSPL versionEffective
49281-562-10ML - Milliliter49281-5625c025688-447b-4033-9ffd-ccdd92626ef112015-05-05
49281-562-58ML - Milliliter49281-562fb3f7446-235b-42b7-9962-1a8983531a5d12015-05-05

DailyMed Socrata Ingredients#

Ingredient, Type, UNII table
IngredientTypeUNIISPL versionUploaded
BORDETELLA PERTUSSIS FILAMENTOUS HEMAGGLUTININ ANTIGEN (FORMALDEHYDE INACTIVATED)ACTIVE INGREDIENT8C367IY4EY1
BORDETELLA PERTUSSIS FIMBRIAE 2/3 ANTIGENACTIVE INGREDIENT1O0600285A1
BORDETELLA PERTUSSIS PERTACTIN ANTIGENACTIVE INGREDIENT63GD90PP8X1
BORDETELLA PERTUSSIS TOXOID ANTIGEN (GLUTARALDEHYDE INACTIVATED)ACTIVE INGREDIENTF4TN0IPY371
CLOSTRIDIUM TETANI TOXOID ANTIGEN (FORMALDEHYDE INACTIVATED)ACTIVE INGREDIENTK3W1N8YP131
CORYNEBACTERIUM DIPHTHERIAE TOXOID ANTIGEN (FORMALDEHYDE INACTIVATED)ACTIVE INGREDIENTIRH51QN26H1
POLIOVIRUS TYPE 1 ANTIGEN (FORMALDEHYDE INACTIVATED)ACTIVE INGREDIENT0LVY784C091
POLIOVIRUS TYPE 2 ANTIGEN (FORMALDEHYDE INACTIVATED)ACTIVE INGREDIENT23JE9KDF4R1
POLIOVIRUS TYPE 3 ANTIGEN (FORMALDEHYDE INACTIVATED)ACTIVE INGREDIENT459ROM8M9M1
BORDETELLA PERTUSSIS FILAMENTOUS HEMAGGLUTININ ANTIGEN (FORMALDEHYDE INACTIVATED)ACTIVE MOIETY8C367IY4EY1
BORDETELLA PERTUSSIS FIMBRIAE 2/3 ANTIGENACTIVE MOIETY1O0600285A1
BORDETELLA PERTUSSIS PERTACTIN ANTIGENACTIVE MOIETY63GD90PP8X1
BORDETELLA PERTUSSIS TOXOID ANTIGEN (GLUTARALDEHYDE INACTIVATED)ACTIVE MOIETYF4TN0IPY371
CLOSTRIDIUM TETANI TOXOID ANTIGEN (FORMALDEHYDE INACTIVATED)ACTIVE MOIETYK3W1N8YP131
CORYNEBACTERIUM DIPHTHERIAE TOXOID ANTIGEN (FORMALDEHYDE INACTIVATED)ACTIVE MOIETYIRH51QN26H1
POLIOVIRUS TYPE 1 ANTIGEN (FORMALDEHYDE INACTIVATED)ACTIVE MOIETY0LVY784C091
POLIOVIRUS TYPE 2 ANTIGEN (FORMALDEHYDE INACTIVATED)ACTIVE MOIETY23JE9KDF4R1
POLIOVIRUS TYPE 3 ANTIGEN (FORMALDEHYDE INACTIVATED)ACTIVE MOIETY459ROM8M9M1
ALBUMIN BOVINEINACTIVE INGREDIENT27432CM55Q1
ALUMINUM PHOSPHATEINACTIVE INGREDIENTF92V3S521O1
FORMALDEHYDEINACTIVE INGREDIENT1HG84L35251
GLUTARALINACTIVE INGREDIENTT3C89M417N1
NEOMYCININACTIVE INGREDIENTI16QD7X2971
PHENOXYETHANOLINACTIVE INGREDIENTHIE492ZZ3T1
POLYMYXIN B SULFATEINACTIVE INGREDIENT19371312D41
POLYSORBATE 80INACTIVE INGREDIENT6OZP39ZG8H1
WATERINACTIVE INGREDIENT059QF0KO0R1

Products#

Every source-derived product name is available through these pages.

DailyMed product names page 1 of 1 · 20 matching rows.

NDC Codes#

Product NDC, Package NDC table
Product NDCPackage NDC
49281-56249281-562-58, 49281-562-10

Purple Book Biologic Products#

BLA, Proprietary name, Proper name table
BLAProprietary nameProper nameLicense typeStatusLatest source
125525QuadracelDiphtheria and Tetanus Toxoids and Acellular Pertussis Adsorbed and Inactivated Poliovirus Vaccine351(a)Disc2026-09-01

Ingredients#

Every source-derived ingredient row is available through these pages.

DailyMed ingredient rows page 1 of 1 · 18 matching rows.

Source Document#

Source XML · Source PDF

Inactive ingredient matches#

Inactive Ingredient Database values describe FDA-listed use contexts. The match method and ambiguity count are shown because ingredient names, routes, and dosage forms are not always unique. Browse recovered IID releases and source provenance.

Inactive ingredient links page 1 of 2 · 85 matching rows.

DailyMed ingredient, IID ingredient, UNII table
DailyMed ingredientIID ingredientUNIIDosage form / routePotencyMaximum daily exposureMatch
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HEMULSION / TOPICAL34050 mgExact identifier — unii candidate
78 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HTABLET, COATED / ORAL18 mgExact identifier — unii candidate
78 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HINJECTION, SUSPENSION / INTRASYNOVIAL4 mgExact identifier — unii candidate
78 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HSUSPENSION/ DROPS / OPHTHALMIC1 mgExact identifier — unii candidate
78 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HCREAM / TOPICAL20 mgExact identifier — unii candidate
78 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HTABLET / ORAL233 mgExact identifier — unii candidate
78 equally ranked IID candidates
GLUTARALGLUTARALT3C89M417NSHAMPOO / TOPICAL0.05 %w/wExact identifier — unii candidate
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HINJECTION, SUSPENSION / INTRA-ARTICULAR4 mgExact identifier — unii candidate
78 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HTABLET, EXTENDED RELEASE / ORAL10 mgExact identifier — unii candidate
78 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HPOWDER / ORAL66 mgExact identifier — unii candidate
78 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HLOTION / TOPICAL15 %w/wExact identifier — unii candidate
78 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HCAPSULE, EXTENDED RELEASE / ORAL10 mgExact identifier — unii candidate
78 equally ranked IID candidates
PHENOXYETHANOLPHENOXYETHANOLHIE492ZZ3TCREAM, AUGMENTED / TOPICAL10 mgExact identifier — unii candidate
6 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HPASTE / ORAL28 mgExact identifier — unii candidate
78 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HINJECTION / INTRALESIONAL4 mgExact identifier — unii candidate
78 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HCONCENTRATE / ORAL1 mg/1mlExact identifier — unii candidate
78 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HSUPPOSITORY / VAGINAL28 mgExact identifier — unii candidate
78 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HINJECTION, SOLUTION, CONCENTRATE / INTRAVENOUS4739 mgExact identifier — unii candidate
78 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HSUSPENSION / AURICULAR (OTIC)1 %w/vExact identifier — unii candidate
78 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HSOLUTION/ DROPS / AURICULAR (OTIC)13 mgExact identifier — unii candidate
78 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HINJECTION / INTRA-ARTICULAR4 mgExact identifier — unii candidate
78 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HSOLUTION / OPHTHALMIC8 mgExact identifier — unii candidate
78 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HINJECTION / INTRAVENOUS4680 mgExact identifier — unii candidate
78 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HINJECTION, SUSPENSION / INTRAVITREAL0.02 %w/vExact identifier — unii candidate
78 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HSYSTEM / TOPICAL28 mgExact identifier — unii candidate
78 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HENEMA / RECTAL0.01 %w/vExact identifier — unii candidate
78 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HCAPSULE / ORAL418.37 mgExact identifier — unii candidate
78 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HDROPS / OPHTHALMIC0.05 %w/wExact identifier — unii candidate
78 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HLIQUID / INTRAVENOUS720 mgExact identifier — unii candidate
78 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HSOLUTION / AURICULAR (OTIC)0.2 %w/wExact identifier — unii candidate
78 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HCAPSULE, DELAYED RELEASE / ORAL23 mgExact identifier — unii candidate
78 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HAEROSOL, FOAM / TOPICAL0.98 %w/wExact identifier — unii candidate
78 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HSUSPENSION, EXTENDED RELEASE / ORAL40 mgExact identifier — unii candidate
78 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HCAPSULE, LIQUID FILLED / ORAL24 mgExact identifier — unii candidate
78 equally ranked IID candidates
PHENOXYETHANOLPHENOXYETHANOLHIE492ZZ3TCREAM / TOPICAL57 mgExact identifier — unii candidate
6 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HPOWDER, FOR SUSPENSION / ORAL396 mgExact identifier — unii candidate
78 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HCAPSULE, COATED / ORAL0.04 mgExact identifier — unii candidate
78 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HTABLET, FILM COATED, EXTENDED RELEASE / ORAL8 mgExact identifier — unii candidate
78 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HINJECTION, SUSPENSION / SOFT TISSUE4 mgExact identifier — unii candidate
78 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HINJECTION, POWDER, FOR SUSPENSION / INTRAMUSCULAR4 mgExact identifier — unii candidate
78 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HSUSPENSION / ORAL206 mgExact identifier — unii candidate
78 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HINJECTION, SUSPENSION / INTRAVENOUS0.5 %w/vExact identifier — unii candidate
78 equally ranked IID candidates
PHENOXYETHANOLPHENOXYETHANOLHIE492ZZ3TLOTION / TOPICAL1 %w/wExact identifier — unii candidate
6 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HOINTMENT / TOPICAL0.1 %w/wExact identifier — unii candidate
78 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HEMULSION / OPHTHALMIC26 mgExact identifier — unii candidate
78 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HINJECTION / INTRAMUSCULAR4 %w/vExact identifier — unii candidate
78 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HINJECTION / INTRASYNOVIAL0.2 %w/vExact identifier — unii candidate
78 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HTABLET, ORALLY DISINTEGRATING, DELAYED RELEASE / ORAL34 mgExact identifier — unii candidate
78 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HSPRAY / NASAL0.01 mgExact identifier — unii candidate
78 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HTABLET, FILM COATED / ORAL24 mgExact identifier — unii candidate
78 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HSOLUTION/ DROPS / OPHTHALMIC0.25 %w/vExact identifier — unii candidate
78 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HCONCENTRATE / INTRAVENOUS4680 mgExact identifier — unii candidate
78 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HGRANULE, FOR SUSPENSION / ORAL240 mgExact identifier — unii candidate
78 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HCAPSULE, COATED PELLETS / ORAL2 mgExact identifier — unii candidate
78 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HGEL / TOPICAL12 mgExact identifier — unii candidate
78 equally ranked IID candidates
PHENOXYETHANOLPHENOXYETHANOLHIE492ZZ3TAEROSOL / TOPICAL1.05 %w/wExact identifier — unii candidate
6 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HELIXIR / ORAL2.5 mg/15mlExact identifier — unii candidate
78 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HINJECTION, SOLUTION / INTRAVENOUS1170 mgExact identifier — unii candidate
78 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HINJECTION, POWDER, LYOPHILIZED, FOR SOLUTION / INTRAVENOUS900 mgExact identifier — unii candidate
78 equally ranked IID candidates
POLYSORBATE 80POLYSORBATE 806OZP39ZG8HINJECTION, POWDER, FOR SUSPENSION / INTRA-ARTICULAR5 mgExact identifier — unii candidate
78 equally ranked IID candidates

Reported adverse events (FAERS/openFDA)#

Adverse event summaries are temporarily unavailable. Other product information remains available.