Tetanus Toxoid

Pronunciation: TET-a-nus TOX-oyd
Class: Bacterial vaccine

Trade Names

Tetanus Toxoid
- Injection, suspension tetanus toxoid 5 flocculation units per 0.5 mL

Pharmacology

Induces antibodies against toxins made by Clostridium tetani .

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Indications and Usage

For active immunization against tetanus.

Contraindications

Hypersensitivity to any component of the vaccine, including thimerosal, or to any other tetanus toxoid–containing vaccine.

Dosage and Administration

Primary Immunization
Adults and Children 7 y and older

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 the second dose.

Booster Doses
Adults and Children 7 y and older

IM 0.5 mL every 10 y to maintain immunity. A booster dose is recommended in patients 11 to 12 y of age if it has been at least 5 y since the last dose of a tetanus toxoid–containing vaccine. If a dose of a tetanus toxoid–containing vaccine is given sooner than 10 y, as part of wound management, or upon exposure to diphtheria, the next booster is not needed for 10 y thereafter.

Tetanus Prophylaxis in Wound Management
Adults and Children 7 y and older Primary immunization complete

IM Administer a 0.5 mL booster dose in patients with minor, uncontaminated wounds only if the patient has not received tetanus toxoid in the past 10 y. For tetanus-prone wounds, administer a 0.5 mL booster dose if the patient has not received a tetanus toxoid–containing preparation within the preceding 5 y.

Primary immunization incomplete or unknown

IM Immunize with a tetanus toxoid–containing product and ensure completion of primary immunization thereafter.

General Advice

  • Administer IM in the area of the vastus lateralis (mid-thigh laterally) or deltoid. Do not inject into the gluteal area or areas where there may be a major nerve trunk.
  • Take special care to ensure the injection does not enter a blood vessel.
  • Shake vial well before withdrawing dose; discard if vaccine cannot be resuspended.
  • Parenteral drug products should be inspected visually for extraneous particulate matter and/or discoloration prior to administration whenever solution and container permit.
  • Interruption of the recommended schedule with a delay between doses should not interfere with the final immunity. There is no need to start the series over again, regardless of time elapsed between doses.
  • Tetanus toxoid may be used to complete the primary immunization series for tetanus in children 7 y and older who have received 1 or 2 doses of whole-cell pertussis DTP, DTaP, and/or DT vaccine.

Storage/Stability

Store between 35° and 46°F. Do not freeze.

Drug Interactions

Immunosuppressive agents

Immunosuppressive therapies may reduce the immune response to vaccines.

Adverse Reactions

Cardiovascular

Hypotension.

CNS

Brachial neuritis, cranial mononeuropathies, demyelinating disease, EEG disturbances with encephalopathy, Guillain-Barré syndrome, malaise, peripheral mononeuropathies.

GI

Nausea.

Hypersensitivity

Allergic or anaphylactic reaction, including difficulty breathing, hives, hypotension, shock, swelling of the mouth; Arthus-type hypersensitivity reactions.

Local

Edema, induration with or without tenderness, rash, redness, urticaria, warmth.

Musculoskeletal

Arthralgia.

Miscellaneous

Pain, transient fever.

Precautions

Pregnancy

Category C .

Lactation

Undetermined.

Children

Not indicated for use in infants and children younger than 7 y.

Hypersensitivity

May occur and is a contraindication to further doses of vaccines with a tetanus component. Patients who have experienced severe Arthus-type hypersensitivity with previous doses of tetanus toxoid should not be given emergency doses of tetanus toxoid more frequently than every 10 y, even if they have a wound that is neither clean nor minor.

Bleeding disorders

Do not give to persons receiving anticoagulant therapy or to those with any bleeding disorder (eg, hemophilia, thrombocytopenia) unless the potential benefits clearly outweigh the risks. If tetanus toxoid is used in such patients, use with caution and take steps to avoid the risk of hematoma following injection.

Guillain-Barré syndrome

Weigh the benefits and risks of giving tetanus toxoid to patients who experienced Guillain-Barré syndrome within 6 wk of receipt of any tetanus toxoid–containing vaccine.

Immunosuppression

Immunocompromised patients may not obtain the expected immune response to vaccination.

Patient Information

  • Inform parents, guardians, or adult patients of the benefits and risks of immunization prior to administration.
  • Inform parents, guardians, or adult patients about the potential for temporal adverse reactions that have been associated with the administration of tetanus toxoid or other vaccines containing similar components. Instruct parents, guardians, or adult patients to report any serious adverse reactions to their health care provider.
  • Inform parents, guardians, or adult patients of the importance of completing the primary immunization series or receiving recommended booster doses as appropriate.
  • Instruct patients to review the Vaccine Information Statements (VIS) that are required by the National Childhood Vaccine Injury Act of 1986 to be given with each immunization.

Copyright © 2009 Wolters Kluwer Health.

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