Merck Manual

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Tetanus-Diphtheria Vaccine

By

Margot L. Savoy

, MD, MPH, Lewis Katz School of Medicine at Temple University

Reviewed/Revised Jul 2023
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Preparations of Tetanus-Diphtheria Vaccine

The most widely used preparations combine tetanus toxoid with diphtheria toxoid (Td for adults; DT, which contains a higher dose of diphtheria toxoid, for children); a preparation with only tetanus toxoid (TT) is also available but is not recommended because periodic boosting is needed for both antigens. Tetanus-diphtheria-pertussis (Tdap Diphtheria-Tetanus-Pertussis Vaccine Vaccines that contain diphtheria toxoid, tetanus toxoid, and acellular pertussis help protect against diphtheria, tetanus, and pertussis, but they do not prevent all cases. For more information... read more ) is an adolescent and adult preparation that contains a pertussis component.

Indications for Tetanus-Diphtheria Vaccine

Tetanus-diphtheria (Td) or Tdap boosters are given routinely every 10 years after the Tdap booster is given at age 11 to 12 years. Patients who have not received or completed a primary vaccination series of at least 3 doses of tetanus and diphtheria vaccine should begin or complete the series. (See Centers for Disease Control and Prevention (CDC) Child and Adolescent Immunization Schedule by Age and Adult Immunization Schedule by Age.)

Patients who have a wound that poses an increased risk of tetanus (see table ) should be given a Td or Tdap booster if ≥ 5 years have elapsed since the previous dose. One dose of Tdap should be substituted for a Td booster if adults have never received Tdap.

Pregnant women should receive 1 dose of Tdap during each pregnancy, irrespective of their history of receiving the vaccine. Tdap should be administered at 27 to 36 weeks gestation, preferably during the earlier part of this period, although it may be administered at any time during pregnancy.

Contraindications and Precautions for Tetanus-Diphtheria Vaccine

Dose and Administration of Tetanus-Diphtheria Vaccine

The Td dose is 0.5 mL IM. Booster vaccinations are given every 10 years.

Adverse Effects of Tetanus-Diphtheria Vaccine

Adverse effects are very rare. They include anaphylactic reactions and brachial neuritis. Mild effects include erythema, swelling, and soreness at the injection site.

More Information

The following English-language resources may be useful. Please note that THE MANUAL is not responsible for the content of these resources.

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NOTE: This is the Professional Version. CONSUMERS: View Consumer Version
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