Tetanus Toxoid Vaccine Type | Usage | Precautions | Side Effects
- Tetanus is a life-threatening disease caused by the spore forming, gram-positive, anaerobic bacteria called Clostridium tetani.
- C. tetani produces tetanospasmin an exotoxin which causes painful muscle spasms especially in jaw, back and facial muscles. Involvement of respiratory muscles can lead to respiratory failure and death. Mortality rate is estimated to be about 10%.
- C. tetani spores are widely found in soil. Most people get infected after these spores enter their body through skin wounds.
- Neonatal tetanus occurs following cutting of umbilical cord in septic environment or non-sterile instruments.
Vaccine Type
- Tetanus Toxoid vaccine.
(Toxin is converted into toxoid by treating it with formaldehyde. Toxoid is immunogenic but does not possess the disease-causing effects of toxin.)
Available as
- DTaP: Pediatric Diphtheria, Tetanus, and acellular Pertussis.
- DT: Pediatric Diphtheria and Tetanus.
- Tdap: Adults Tetanus, Diphtheria and acellular Pertussis
- Td: Adults Tetanus and Diphtheria.
- DTaP and DT are used in infants and children younger than 7 years, while Tdap and Td are for use in older children and adults.
Tetanus Immunoglobulin (TIG): TIG is used to provide passive immunity against tetanus for certain people after suspected exposure
to tetanus spores
Usage
- Children: All children should be vaccinated against tetanus, using DTaP vaccine. Those children who are allergic to acellular pertussis should receive DT instead of DTaP. DTaP is given in a 5 dose schedule as follows:
1) 2 months
2) 4 months
3) 6 months
4) 15-18 months
5) 4-6 years of age.
- Adults:
- Td: People older than 11 years should receive a booster dose of tetanus toxoid in the form of Td every 10 years, or after exposure to tetanus in some circumstances.
- Tdap: It is similar to Td but also contains acellular pertussis vaccine. All teens and pre-teens should receive a one-time booster dose of Tdap in place of Td. Adults who have not received Tdap in their teens should also receive one-time booster dose of Tdap.
- Pregnant Women:
- Pregnant women should receive a dose of Tdap during each pregnancy, preferably at 27 through 36 weeks to maximize the amount of protective antibodies passed to the baby, but the vaccine can be safely given at any time during pregnancy.
- New mothers who have never gotten Tdap should get a dose as soon as possible after delivery.
- Post-exposure Prophylaxis: All wounds potentially put the patient at risk of getting tetanus. Proper wound care and debridement are very important for prevention of tetanus.
- Clean, minor wounds: If the patient has not received TT-containing vaccine in the previous 10 years, he should receive a booster dose.
- All other wounds: A person who has completed primary tetanus immunization should receive a single booster dose of TT if he has not received tetanus vaccine in the previous 5 years.
Those who have not completed primary immunization or whose vaccination record is uncertain should receive a single dose Tetanus Immunoglobulin (TIG) along with a TT booster dose.
Precautions
DTaP:
- Not for use in anyone aged 7 years or above.
- Children who had severe allergic reaction to previous dose of the vaccine, and children who suffered a nervous system disease within 7 days after a shot of DTaP should not get another dose.
- Consult before usage if a child has had seizure attack or fever of more than 105 F after a previous dose of the vaccine.
- Children with uncontrolled neurologic disorder or seizure should not receive pertussis containing vaccine until their condition is stable.
- Some of these effects are due to pertussis vaccine. Such children may be advised to receive DT instead DTaP.
Tdap and Td:
- Severe allergic reaction to a previous of the vaccine contraindicates further vaccination with these vaccine.
- Pertussis containing vaccine (i.e. Tdap) is contraindicated in those who had encephalopathy within 7 days after a previous dose of the vaccine.
- Children with uncontrolled neurologic disorder or seizure should not receive pertussis containing vaccine until their condition is stable, or should receive Td instead.
Other Precautions:
- Patients who had an episode of Guillain-Barre syndrome within 6 weeks after a previous dose of tetanus-toxoid containing vaccine should not receive another dose or if clearly needed should do so with caution.
- Patients who had Arthus-type reaction to a previous dose of TT containing vaccination should defer vaccination until at least 10 years after the last dose.