(Elanco) IBR, BVD, PI3, BRSV, Mannheimia haemolytica, and Pasteurella multocida. Titanium 5 + PH-M delivers proven broad immune response against both bacteria and viruses most associated with BRD in a single vaccine for calves as young as two months of age. Titanium 5 + PH-M is the only combination product that contains M. haemolytica, P. multocida, and a leukotoxoid. Give 2 mL SQ, followed by a second dose of monovalent BRSV vaccine (Titanium BRSV) and M. haemolytica and P. multocida vaccine (PULMO-GUARD PH-M) to be given 14 to 28 days after the first dose. Titanium 5 + PH-M may be administered to pregnant cattle provided they were vaccinated, according to label directions, with Titanium 3, Titanium 4 L5, Titanium 5, Titanium 5 L5 HB, or Titanium 5 + PH-M 30 to 60 days prior to breeding. Titanium 5 + PH-M may also be administered to calves nursing pregnant cows provided their dams were vaccinated as described above. Calves vaccinated before weaning should be revaccinated 30 days after weaning. Annual booster is recommended. Modified live, requires mixing.