No

Toxoid

Selective induction of active immunity against tetanus in selected patients. Note: Tetanus and diphtheria toxoids for adult use (Td) is the preferred immunizing agent for most adults and for children after their seventh birthday. Young children should receive trivalent DTwP or DTaP (diphtheria/tetanus/pertussis - whole cell or acellular), as part of their childhood immunization program, unless pertussis is contraindicated, then TD is warranted.

C

Hypersensitivity to tetanus toxoid or any component (may use the fluid tetanus toxoid to immunize the rare patient who is hypersensitive to aluminum adjuvant); avoid use with chloramphenicol or if neurological signs or symptoms occurred after prior administration; poliomyelitis outbreaks require deferral of immunizations; acute respiratory infections or other active infections may dictate deferral of administration of routine primary immunizing but not emergency doses

Not equivalent to tetanus toxoid fluid; the tetanus toxoid adsorbed is the preferred toxoid for immunization and Td, TD or DTaP/DTwP are the preferred adsorbed forms; avoid injection into a blood vessel; have epinephrine (1:1000) available; not for use in treatment of tetanus infection nor for immediate prophylaxis of unimmunized individuals; immunosuppressive therapy or other immunodeficiencies may diminish antibody response, however it is recommended for routine immunization of symptomatic and asymptomatic HIV-infected patients; deferral of immunization until immunosuppression is discontinued or administration of an additional dose >1 month after treatment is recommended; allergic reactions may occur; epinephrine 1:1000 must be available; use in pediatrics should be deferred until >1 year of age when a history of a CNS disorder is present; elderly may not mount adequate antibody titers following immunization

>10%: Local: Induration/redness at injection site

1% to 10%:

Central nervous system: Chills, fever

Local: Sterile abscess at injection site

Miscellaneous: Allergic reaction

<1%: Fever >103°F, malaise, neurological disturbances, blistering at injection site, Arthus-type hypersensitivity reactions

Decreased response: If primary immunization is started in individuals receiving an immunosuppressive agent or corticosteroids, serologic testing may be needed to ensure adequate antibody response; concurrent use of TIG and tetanus toxoid may delay the development of active immunity by several days

Refrigerate, do not freeze

Tetanus toxoid preparations contain the toxin produced by virulent tetanus bacilli (detoxified growth products of Clostridium tetani). The toxin has been modified by treatment with formaldehyde so that it has lost toxicity but still retains ability to act as antigen and produce active immunity; the aluminum salt, a mineral adjuvant, delays the rate of absorption and prolongs and enhances its properties; duration ~10 years.

Duration of immunization following primary immunization: ~10 years

Adults: I.M.:

Routine booster doses are recommended only every 5-10 years

Inject intramuscularly in the area of the vastus lateralis (midthigh laterally) or deltoid

No information available to require special precautions

No effects or complications reported

A nodule may be palpable at the injection site for a few weeks. DT, Td and T vaccines cause few problems; they may cause mild fever or soreness, swelling, and redness where the shot was given. These problems usually last 1-2 days, but this does not happen nearly as often as with DTP vaccine. Sometimes, adults who get these vaccines can have a lot of soreness and swelling where the shot was given.

Injection, adsorbed:

Tetanus 10 Lf units per 0.5 mL dose (0.5 mL, 5 mL)

Bentley DW, "Vaccinations," Clin Geriatr Med, 1992, 8(4):745-60.

Gardner P and Schaffner W, "Immunization of Adults," N Engl J Med, 1993, 328(17):1252-8.