What is Tetanus Toxoid
Tetanus toxoid is used to provide active immunity against tetanus. As acquired immunity to tetanus toxin does not occur in the U.S., primary vaccination and booster vaccination with tetanus toxoid are required to protect persons of all age groups.
Immunization with tetanus toxoid is effective in producing serum antitoxin concentrations for at least 10 years.
Tetanus toxoid is currently recommended for primary or booster immunization for all infants 6—8 weeks of age and older, all children, and all adults.
In children <7 years old, tetanus toxoid is usually administered as the trivalent diphtheria and tetanus toxoids and pertussis vaccine adsorbed (DTP) or as diphtheria and tetanus toxoids for pediatric use (DT).
The combination of tetanus and diphtheria toxoids (Td) for adult use is recommended in older children and adults.
The single-agent formulation of tetanus toxoid is available as tetanus toxoid fluid (TT) or tetanus toxoid adsorbed (TTA) to aluminum hydroxide, aluminum phosphate, or potassium alum.
Tetanus toxoid fluid and TTA are mostly used in emergency situations and in patients who have a contraindication to combined antigens. Because of greater antigenic effects, TTA is the preferred single-agent formulation.
Tetanus toxoid fluid is the formulation of choice in patients who are hypersensitive to the aluminum adjuvant in TTA, and it is also used to demonstrate delayed-hypersensitivity reactions in HIV-seropositive patients.
Tetanus toxoid is not for treating an active tetanus infection, which should be treated by administering tetanus immune globulin (see Tetanus Immune Globulin monograph).
Tetanus toxoid should, however, be administered once the infection is adequately treated.
A peripheral benefit of vaccination against tetanus may be a reduction in the risk for multiple sclerosis (MS) development.
Patients with a history of tetanus vaccination had an odds of developing either MS or optic neuritis of 0.6 (95% CI, 0.4—0.8) the odds of disease development in nonvaccinated patients.
Further, combined data from 9 case-control studies yielded a similar OR of 0.67 (95% CI, 0.55—0.81) for MS and tetanus vaccination.
Indications
- tetanus prophylaxis
Side Effects
- anaphylactic shock
- anaphylactoid reactions
- angioedema
- arthralgia
- Arthus reaction
- dyspnea
- EEG changes
- encephalopathy
- erythema
- fever
- Guillain-Barre syndrome
- hypotension
- injection site reaction
- malaise
- myalgia
- nausea
- neuritis
- rash
- urticaria
Monitoring Parameters
- laboratory monitoring not necessary
Contraindications
- anticoagulant therapy
- breast-feeding
- coagulopathy
- hemophilia
- immunosuppression
- neurological disease
- pregnancy
- radiation therapy
- seizures
- thimerosal hypersensitivity
- thrombocytopenia
- vitamin K deficiency
Interactions
- Adalimumab
- Fingolimod
- Ocrelizumab
- Rh0 [D] Immune Globulin
- Siponimod
