Tetanus Toxoid

Key Information

• Disease: Tetanus (lockjaw) is caused by Clostridium tetani and occurs worldwide.
• Vaccine: Tetanus toxoid is only available in combination vaccines.
• Immunization: A primary series and boosters are recommended to maintain high levels of tetanus antibody.

Recommendations for Use

• Routine Immunization:
• Infants and Children: Administer DTaP-IPV-Hib vaccine at 2, 4, 6, and 12-23 months of age, with boosters at 4-6 years and 14-16 years.
• Adults: Administer one dose of Tdap if not previously received in adulthood and a Td booster every 10 years.
• Post-exposure Prophylaxis: Administer tetanus toxoid-containing vaccine, with or without tetanus immunoglobulin (TIg), depending on wound type and vaccination history.

Vaccine Preparations Authorized for Use in Canada

• Vaccines:
  • ADACEL® (Tdap)
  • ADACEL®-POLIO (Tdap-IPV)
  • BOOSTRIX® (Tdap)
  • BOOSTRIX®-POLIO (Tdap-IPV)
  • INFANRIX®-IPV/Hib (DTaP-IPV-Hib)
  • INFANRIX hexa™ (DTaP-HB-IPV-Hib)
  • PEDIACEL® (DTaP-IPV-Hib)
  • QUADRACEL® (DTaP-IPV)
  • Td ADSORBED (Td)
• Tetanus Immunoglobulin:
  • HYPERTET®S/D
  • HyperTET®

Efficacy, Effectiveness, and Immunogenicity

• Efficacy: More than 99% of vaccinees develop protective antibody concentrations after a complete primary series.
• Effectiveness: Observational studies confirm the effectiveness in preventing tetanus, with very few cases in fully immunized individuals.

Vaccine Administration

• Dose: 0.5 mL
• Route: Intramuscular injection
• Schedule:
• Infants: 2, 4, 6, and 12-23 months
• Children: Boosters at 4-6 years and 14-16 years
• Adults: Primary series if not previously immunized, with boosters every 10 years

Adverse Reactions

• Common: Redness, swelling, and pain at the injection site, mild fever, irritability.
• Severe: Rarely, anaphylaxis, Guillain-Barré syndrome, or severe local reactions.

Post-exposure Prophylaxis Guidelines

• Administer tetanus toxoid-containing vaccine based on wound severity and immunization history, possibly combined with TIg for immediate protection.