Sanofi’s pediatric vaccine “Hexaxim” remains the most administered hexavalent vaccine in the world with 62% share by volume

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Building on a previous study, this new white paper provides detailed insights into the usage patterns of pediatric aP hexavalent vaccines, the volumes administered by region and country, and the leading manufacturers. The report examines 102 countries in which hexavalent brands were registered in 2019.

To download your copy, simply click here.

Hexavalent vaccines benefit both infants and governments.

Hexavalent vaccines are six in-one (or 5+1) combination vaccines recommended for administration in three or four doses to protect babies under one year old against diphtheria, tetanus, pertussis (whooping cough), poliomyelitis, haemophilus influenza type B and hepatitis B.

By including six antigens in a single dose, hexavalent vaccines reduce the complications associated with multiple intramuscular injections, lower the risk of delayed or missed vaccinations, and provide access to inactivated polio vaccine (PIV). They also reduce stocking and administration costs.

38 million doses of hexavalent vaccine administered in 2019.

The study found that 326 million doses of DTP-based combination vaccines were consumed last year. DTaP vaccines (combined vaccines against diphtheria, tetanus and pertussis in which the pertussis component is acellular) had a minority presence, representing 75 million doses or 23% of the global total.

Within DTaP vaccines, the market is shifting decisively towards hexavalent variants. They accounted for 50% of the total, an increase from 47% in 2018.

Usage was relatively concentrated: 35 countries represented 92% of the hexavalent doses administered in 2019. These countries are geographically diverse, with the highest rates of consumption being seen in Mexico (5.36 million doses), South Africa (3.53 million doses); Germany, Vietnam, the United Kingdom and France (more than 2 million doses each). Overall, Europe accounted for 42% of the hexavalent vaccines market by volume.

2019 hexavalent vaccine volume analysis by region

Globally, Hexaxim is the leader in hexavalent vaccines.

There are three brands of pediatric hexavalent vaccine commercially available: Hexaxim/Hexyon/ Hexacima (manufactured by Sanofi Pasteur); Infanrix Hexa (GlaxoSmithKline); and Vaxelis (MCM Vaccine Company, a joint venture between Sanofi Pasteur and Merck).

 In 2019, Hexaxim was the clear market leader by volume with 62% (approximately 22m doses), followed by Infanrix Hexa with 32% and Vaxelis with 6%.

2019 share of hexavalent vaccine brands in top 35 countries

In public markets (those where the Government bears part or all of the cost of immunisation), Hexaxim had an even higher volume share of 69%. It was the only brand used in the national immunisation schedule in twelve public markets: South Africa, Saudi Arabia, Mexico, Iraq, Libya, Chile, Panama, Kazakhstan, Belgium, Austria, Norway and Georgia. 

Analysis of vaccinations for pre-term infants (babies born alive before 37 weeks of pregnancy) showed that Hexaxim was the most used pre-term hexavalent vaccine, with a volume share of 66% or approximately 1.7 million doses.

The study concludes that fully liquid, ready-to-use hexavalent vaccines like Hexaxim are more widely administered than reconstituted hexavalent vaccines, and should be considered a standard of care globally.

Find out more about hexavalent vaccines.

A White Paper To Understand The Market Structure of Pediatric Pertussis Combination Vaccines contains rich data on the usage of hexavalent and other DTB-based multivalent vaccines around the world. To download your copy, click here.


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