tetanus and diphtheria toxoids vaccine

Generic Name: tetanus and diphtheria toxoids vaccine (Td, adult) (TET a nus and dif THEER ee a TOX oyds vax EEN)
Brand Name: Decavac (Td), Tenivac (Td), Tetanus-Diphtheria Toxoids, Adult (Td), Tetanus-Diphtheria Toxoids, Adult (Td)

What is tetanus and diphtheria toxoids (Td, adult) vaccine?

Diphtheria and tetanus are serious diseases caused by bacteria.

Diphtheria causes a thick coating in the nose, throat, and airways. It can lead to breathing problems, paralysis, heart failure, or death.

Tetanus (lockjaw) causes painful tightening of the muscles, usually all over the body. It can lead to "locking" of the jaw so the victim cannot open the mouth or swallow. Tetanus leads to death in about 1 out of 10 cases.

Diphtheria is spread from person to person. Tetanus enters the body through a cut or wound.

The tetanus and diphtheria toxoids vaccine (also called Td) is used to help prevent these diseases in adults and children who are at least 7 years old.

This vaccine works by exposing you to a small dose of the bacteria or a protein from the bacteria, which causes the body to develop immunity to the disease. This vaccine will not treat an active infection that has already developed in the body.

Like any vaccine, the tetanus and diphtheria toxoids vaccine may not provide protection from disease in every person.

What is the most important information I should know about this vaccine?

You should not receive this vaccine if you have ever had a life-threatening allergic reaction to any vaccine containing diphtheria or tetanus, if you have an uncontrolled seizure disorder, or if you have received a cancer treatment in the past 3 months.

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What should I discuss with my healthcare provider before receiving this vaccine?

You should not receive this vaccine if you have ever had a life-threatening allergic reaction to any vaccine containing diphtheria or tetanus, or if you have:

  • uncontrolled epilepsy or other seizure disorder; or

  • if you have received cancer chemotherapy or radiation treatment in the past 3 months.

You may not be able to receive this vaccine if you have ever received a similar vaccine that caused any of the following:

  • a very high fever (over 104 degrees);

  • fainting or going into shock;

  • Guillain-Barré syndrome (within 6 weeks after receiving a diphtheria, tetanus, or pertussis vaccine);

  • seizure (convulsions); or

  • a severe skin reaction.

If you have any of these other conditions, your vaccine may need to be postponed or not given at all:

  • a bleeding or blood clotting disorder such as hemophilia or easy bruising;

  • a history of seizures;

  • a neurologic disorder or disease affecting the brain (or if this was a reaction to a previous vaccine);

  • an allergy to latex rubber;

  • a weak immune system caused by disease, bone marrow transplant, or by using certain medicines or receiving cancer treatments; or

  • if you are taking a blood thinner such as warfarin (Coumadin).

You can still receive a vaccine if you have a minor cold. In the case of a more severe illness with a fever or any type of infection, wait until you get better before receiving this vaccine.

Vaccines may be harmful to an unborn baby and generally should not be given to a pregnant woman. However, not vaccinating the mother could be more harmful to the baby if the mother becomes infected with a disease that this vaccine could prevent. Your doctor will decide whether you should receive this vaccine, especially if you have a high risk of infection with diphtheria or tetanus.

It is not known whether this vaccine passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

The adult version of this vaccine (Td) should not be given to anyone under the age of 7 years old. Another vaccine is available for use in younger children and infants.

How is this vaccine given?

This vaccine is injected into a muscle. You will receive this injection in a doctor's office or clinic setting.

This vaccine is given in a series of shots. The first shot is usually given to a person who is at least 7 years old. The booster shots are then given 4 to 8 weeks after the first shot, and 6 to 12 months after the second shot. After the initial series, a booster dose is given every 10 years.

A booster shot is also recommended in children who are 11 or 12 years old if more than 5 years have passed since the child's last tetanus and diphtheria vaccine.

If it has been longer than 5 years since your last booster, you may need an emergency booster shot if you have been exposed to tetanus through a skin wound.

Your booster schedule may be different from these guidelines. Follow your doctor's instructions or the schedule recommended by your local health department.

Your doctor may recommend treating fever and pain with an aspirin free pain reliever such as acetaminophen (Tylenol) or ibuprofen (Motrin, Advil, and others) when the shot is given and for the next 24 hours. Follow the label directions or your doctor's instructions about how much of this medicine to use.

It is especially important to prevent fever from occurring if you have a seizure disorder such as epilepsy.

What happens if I miss a dose?

Contact your doctor if you miss a booster dose or if you get behind schedule. The next dose should be given as soon as possible. There is no need to start over.

Be sure to receive all recommended doses of this vaccine. You may not be fully protected if you do not receive the full series.

What happens if I overdose?

An overdose of this vaccine is unlikely to occur.

What should I avoid before or after receiving this vaccine?

Follow your doctor's instructions about any restrictions on food, beverages, or activity.

This vaccine side effects

You should not receive a booster vaccine if you had a life threatening allergic reaction after the first shot.

Keep track of any and all side effects you have after receiving this vaccine. When you receive a booster dose, you will need to tell the doctor if the previous shot caused any side effects.

Becoming infected with tetanus or diphtheria is much more dangerous to your health than receiving this vaccine. However, like any medicine, this vaccine can cause side effects but the risk of serious side effects is extremely low.

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any of these serious side effects:

  • extreme drowsiness, fainting;

  • severe headache or vomiting;

  • confusion, seizure (black-out or convulsions); or

  • high fever (within a few hours or a few days after the vaccine).

Common side effects include:

  • redness, pain, tenderness, swelling, or a lump where the shot was given;

  • mild fever;

  • joint pain, body aches;

  • mild drowsiness; or

  • mild vomiting.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report vaccine side effects to the US Department of Health and Human Services at 1-800-822-7967.

See also: Side effects (in more detail)

Tetanus and diphtheria toxoids vaccine dosing information

Usual Adult Dose for Diphtheria Prophylaxis:

2 doses of 0.5 mL IM 4 to 6 weeks apart followed by a third dose of 0.5 mL after 6 to 12 months later.

A booster dose is recommended every 10 years.

Tetanus prophylaxis in wound management:
Use of tetanus toxoid (DT or Td) and/or tetanus immune globulin (TIG) depends upon the number of prior tetanus toxoid (TT) doses and type of wound: A single 0.5 mL dose IM:
Clean, minor wounds:
Prior number of tetanus toxoid doses is unknown or less than 3: DT or Td or Tdap
Prior number of tetanus toxoid doses is 3 or more: Td only if more than 10 years since last dose
If only three doses of fluid tetanus toxoid have been received, a fourth dose of toxoid, preferably an adsorbed toxoid, should be given.
All other wounds:
Prior number of tetanus toxoid doses is unknown or less than 3: DT or Td or Tdap (tetanus/diphtheria/pertussis, accel) and TIG (tetanus immune globulin)
Prior number of tetanus toxoid doses is 3 or more: Td only if more than 5 years since last dose

Use of combined antigen immunization (DT, Td, or DTaP - diphtheria/tetanus/pertussis, accel) is preferred. Use tetanus and diphtheria toxoids formulation based upon age; use pediatric preparations (DT or DTaP) if the patient is less than 7 years old and Td if 7 years or older. Tdap is preferred in adolescents 10 years or older and adults who have never received Tdap. Td is preferred to TT in adolescents 10 years or older and adults who received Tdap previously or when Tdap is not available. If TT and TIG are both used, tetanus toxoid (adsorbed) rather than tetanus toxoid (fluid) should be used.

Usual Adult Dose for Tetanus Prophylaxis:

2 doses of 0.5 mL IM 4 to 6 weeks apart followed by a third dose of 0.5 mL after 6 to 12 months later.

A booster dose is recommended every 10 years.

Tetanus prophylaxis in wound management:
Use of tetanus toxoid (DT or Td) and/or tetanus immune globulin (TIG) depends upon the number of prior tetanus toxoid (TT) doses and type of wound: A single 0.5 mL dose IM:
Clean, minor wounds:
Prior number of tetanus toxoid doses is unknown or less than 3: DT or Td or Tdap
Prior number of tetanus toxoid doses is 3 or more: Td only if more than 10 years since last dose
If only three doses of fluid tetanus toxoid have been received, a fourth dose of toxoid, preferably an adsorbed toxoid, should be given.
All other wounds:
Prior number of tetanus toxoid doses is unknown or less than 3: DT or Td or Tdap (tetanus/diphtheria/pertussis, accel) and TIG (tetanus immune globulin)
Prior number of tetanus toxoid doses is 3 or more: Td only if more than 5 years since last dose

Use of combined antigen immunization (DT, Td, or DTaP - diphtheria/tetanus/pertussis, accel) is preferred. Use tetanus and diphtheria toxoids formulation based upon age; use pediatric preparations (DT or DTaP) if the patient is less than 7 years old and Td if 7 years or older. Tdap is preferred in adolescents 10 years or older and adults who have never received Tdap. Td is preferred to TT in adolescents 10 years or older and adults who received Tdap previously or when Tdap is not available. If TT and TIG are both used, tetanus toxoid (adsorbed) rather than tetanus toxoid (fluid) should be used.

Usual Pediatric Dose for Diphtheria Prophylaxis:

7 years and older:
Primary Immunization:
2 doses of 0.5 mL IM 4 to 6 weeks apart followed by a third dose of 0.5 mL after 6 to 12 months later.
Booster Immunization:
Children 11 to 12 years: A single dose when at least 5 years have elapsed since last dose of toxoid containing vaccine.

Tetanus prophylaxis in wound management:
Use of tetanus toxoid (DT or Td) and/or tetanus immune globulin (TIG) depends upon the number of prior tetanus toxoid (TT) doses and type of wound: A single 0.5 mL dose IM:
Clean, minor wounds:
Prior number of tetanus toxoid doses is unknown or less than 3: DT or Td or Tdap
Prior number of tetanus toxoid doses is 3 or more: Td only if more than 10 years since last dose
If only three doses of fluid tetanus toxoid have been received, a fourth dose of toxoid, preferably an adsorbed toxoid, should be given.
All other wounds:
Prior number of tetanus toxoid doses is unknown or less than 3: DT or Td or Tdap (tetanus/diphtheria/pertussis, accel) and TIG (tetanus immune globulin)
Prior number of tetanus toxoid doses is 3 or more: Td only if more than 5 years since last dose.

Use of combined antigen immunization (DT, Td, or DTaP - diphtheria/tetanus/pertussis, accel) is preferred. Use tetanus and diphtheria toxoids formulation based upon age; use pediatric preparations (DT or DTaP) if the patient is less than 7 years old and Td if 7 years or older. Tdap is preferred in adolescents 10 years or older and adults who have never received Tdap. Td is preferred to TT in adolescents 10 years or older and adults who received Tdap previously or when Tdap is not available. If TT and TIG are both used, tetanus toxoid (adsorbed) rather than tetanus toxoid (fluid) should be used.

Usual Pediatric Dose for Tetanus Prophylaxis:

7 years and older:
Primary Immunization:
2 doses of 0.5 mL IM 4 to 6 weeks apart followed by a third dose of 0.5 mL after 6 to 12 months later.
Booster Immunization:
Children 11 to 12 years: A single dose when at least 5 years have elapsed since last dose of toxoid containing vaccine.

Tetanus prophylaxis in wound management:
Use of tetanus toxoid (DT or Td) and/or tetanus immune globulin (TIG) depends upon the number of prior tetanus toxoid (TT) doses and type of wound: A single 0.5 mL dose IM:
Clean, minor wounds:
Prior number of tetanus toxoid doses is unknown or less than 3: DT or Td or Tdap
Prior number of tetanus toxoid doses is 3 or more: Td only if more than 10 years since last dose
If only three doses of fluid tetanus toxoid have been received, a fourth dose of toxoid, preferably an adsorbed toxoid, should be given.
All other wounds:
Prior number of tetanus toxoid doses is unknown or less than 3: DT or Td or Tdap (tetanus/diphtheria/pertussis, accel) and TIG (tetanus immune globulin)
Prior number of tetanus toxoid doses is 3 or more: Td only if more than 5 years since last dose.

Use of combined antigen immunization (DT, Td, or DTaP - diphtheria/tetanus/pertussis, accel) is preferred. Use tetanus and diphtheria toxoids formulation based upon age; use pediatric preparations (DT or DTaP) if the patient is less than 7 years old and Td if 7 years or older. Tdap is preferred in adolescents 10 years or older and adults who have never received Tdap. Td is preferred to TT in adolescents 10 years or older and adults who received Tdap previously or when Tdap is not available. If TT and TIG are both used, tetanus toxoid (adsorbed) rather than tetanus toxoid (fluid) should be used.

What other drugs will affect tetanus and diphtheria toxoids vaccine?

Before receiving this vaccine, tell your doctor about all other vaccines you have recently received.

Also tell the doctor if you have recently received drugs or treatments that can weaken the immune system, including:

  • an oral, nasal, inhaled, or injectable steroid medicine;

  • medications to treat psoriasis, rheumatoid arthritis, or other autoimmune disorders; or

  • medicines to treat or prevent organ transplant rejection.

If you are using any of these medications, you may not be able to receive the vaccine, or may need to wait until the other treatments are finished.

This list is not complete. Other drugs may interact with tetanus and diphtheria toxoids vaccine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your doctor or pharmacist may have information about this vaccine written for health professionals that you may read. You may also find additional information from your local health department or the Centers for Disease Control and Prevention.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 3.01. Revision Date: 2013-07-16, 2:31:15 PM.

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