Tetanus and Diphtheria Toxoids

Pronunciation: TET-ah-nus and diff-THEER-ee-uh toxoids
Class: Toxoid Tetanus and Diphtheria Toxoids ()

Pharmacology

Induces antibodies against toxins made by Corynebacterium diphtheriae and Clostridium tetani .

Indications and Usage

Achievement of active immunity against diphtheria and tetanus. Tetanus and diphtheria toxoids (Td) for adult use is preferred agent for immunizing most adults and children older than 7 yr of age.

Contraindications

Immediate hypersensitivity to product, thimerosal, or any product components; during immunosuppression, acute respiratory tract infection (except for emergency booster recall doses).

Dosage and Administration

IM A total of 3 doses (0.5 mL each): 1 dose now followed by 1 dose 4 to 8 wk later and then 1 dose 6 to 12 mo after first dose.

IM 0.5 mL at 10-yr intervals throughout life to maintain immunity.

Drug Interactions

None well documented.

Laboratory Test Interactions

None well documented.

Adverse Reactions

Local

Small amount of erythema, induration, pain, tenderness, heat, and edema surrounding injection site, persisting for a few days, is not unusual. Nodule may be palpable at injection site for a few weeks. Allow such nodules to recede spontaneously. Sterile abscess and subcutaneous atrophy occur rarely. Adverse reactions often associated with multiple prior booster doses may be manifested 2 to more than 12 h after administration by erythema, boggy edema, pruritus, lymphadenopathy, and induration surrounding point of injection. Pain and tenderness, if present, are usually not primary complaints.

Systemic

Transient low-grade fever (temperatures over 38°C [100°F]) following Td administration are unusual; chills, malaise, generalized aches and pains, headaches, flushing, generalized urticaria or pruritus, tachycardia, anaphylaxis, hypotension, neurologic complications. People developing significant adverse reactions should not be given Td, even emergency doses, more frequently than every 10 yr.

Precautions

Pregnancy

Category C .

Lactation

Undetermined.

Anticoagulant therapy

As with all IM injections, give drug with caution to people receiving anticoagulant therapy.

Susceptibility

Like all inactivated vaccines, administration of Td to people receiving immunosuppressant drugs, including high-dose corticosteroids or radiation therapy, may result in insufficient response to immunization. They may remain susceptible despite immunization.

Patient Information

• Explain that pain, edema, or pruritus may be experienced at site of injection.
• Stress to family that patient must receive all 3 doses for immunization to be effective.
• Explain need for booster at 10-yr intervals.

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