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Tetanus Toxoid Dosage

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Usual Adult Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for Tetanus Prophylaxis

Primary Immunization - Series of three doses:
0.5 mL IM of tetanus toxoid adsorbed once, followed by a second dose 4 to 8 weeks later, and the third dose given 6 to 12 months after the second dose.

Routine Booster injection:
0.5 mL IM of tetanus toxoid adsorbed or 0.5 mL IM or subcutaneously of tetanus toxoid given 10 years after completion of primary immunization and every 10 years thereafter. If a dose is given sooner as part of wound management, the next booster is not needed for 10 years thereafter.

Usual Pediatric Dose for Tetanus Prophylaxis

>=7 years
Primary Immunization - Series of three doses:
0.5 mL IM of tetanus toxoid adsorbed once, followed by a second dose 4 to 8 weeks later, and the third dose given 6 to 12 months after the second dose.

Routine Booster injection:
0.5 mL IM of tetanus toxoid adsorbed or 0.5 mL IM or subcutaneously of tetanus toxoid given 10 years after completion of primary immunization and every 10 years thereafter. If a dose is given sooner as part of wound management, the next booster is not needed for 10 years thereafter.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Dose Adjustments

Children older than 7 years who did not complete primary immunization series (e.g., previously received only two doses of DTaP or DTP) need to receive only one dose of tetanus toxoid adsorbed vaccine to complete the primary series of tetanus.

Booster injection after injury (>=7 years):
- If primary immunization confirmed and the wound is clean and minor: no need for injection.
- If unknown or uncertain prior immunization (or less than 3 doses) in clean, minor wound: 0.5 mL IM.
- All other dirty wounds (contaminated with feces, soil, and saliva): 0.5 mL IM along with tetanus immune globulin. The next booster dose not needed for 10 years thereafter.

Precautions

The manufacturer states that tetanus toxoid adsorbed and tetanus toxoid are not indicated for use in children younger than 7 years of age.

Tetanus toxoid is not recommended for primary immunization.

Tetanus toxoid is interchangeable with tetanus toxoid adsorbed (contains aluminum) as a booster, and would only be preferred if aluminum is contraindicated.

Tetanus toxoid should not be used in a patient with an active tetanus infection.

Do not inject in the gluteal area or areas where there may be a major nerve trunk or blood vessel.

Persons who experience Arthus-type hypersensitivity reactions or temperature greater than 39.4°C (103°F) after a previous dose of tetanus toxoid usually have very high serum tetanus antibody levels and should not be given even emergency doses of tetanus toxoid more frequently than every 10 years, even if they have a wound that is neither clean nor minor.

Tetanus toxoid should not be given to individuals with thrombocytopenia or any coagulation disorder that would contraindicate intramuscular injection, unless the potential benefit clearly outweighs the risk of administration. If the decision is made to administer tetanus toxoid to individuals with coagulation disorders, it should be given with caution.

Deferral of administration of tetanus toxoid may be considered in individuals receiving immunosuppressive therapy if it will be discontinued shortly. Patients with impaired immune responsiveness, whether due to the use of immunosuppressive therapy (including irradiation, systemic corticosteroids, antimetabolites, alkylating agents, and cytotoxic agents), a genetic defect, HIV, leukemia, lymphoma, generalized malignancy, or other causes, may have a reduced antibody response to active immunization procedures.

Dialysis

Data not available

Other Comments

The injection is administered intramuscularly into the anterolateral aspect of the thigh or the deltoid muscle of the upper arm.

In wound prophylaxis for patients =>7 years, it is advisable to use tetanus/diphtheria (Td ) instead of tetanus toxoid alone in order to maintain adequate levels of diphtheria immunity.

For either primary or booster immunization against tetanus disease in children <7 years, the use of diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP) is recommended.

Interruption of the recommended schedule with a delay between doses does not interfere with the final immunity achieved with tetanus toxoid. There is no need to start the series over again, regardless of the length of time elapsed between doses.

Common adverse reactions and all serious reactions that occur during administration should be reported to the U.S. Department of Health and Human Services Vaccine Adverse Event Reporting System. Reporting forms and information regarding the completion of the form can be obtained at 1-800-822-7967.

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