Tetanus toxoid (Absorbed Tetanus) Vaccine
Indications
Tetanus toxoid (Absorbed Tetanus) Vaccine is used for:
For the active immunization of infants, children 7 years of age or older and adults against, tetanus, wherever combined antigen preparations are not indicated.
For the prevention of neonatal tetanus in infants by immunizing women of childbearing age or infants born of unvaccinated pregnant women.
Those who are liable to be exposed to, tetanus infection, and persons engaged in outdoor activities e.g. gardeners, agricultural, veterinary, athletes, industrial, sewage, road and outdoor workers, etc.
Adult Dose
Primary immunization for persons 7 years of age and older:
A series of three doses of 0.5 ml each, of adsorbed tetanus vaccine should be given intramuscularly;
First dose: At appropriate date, Second dose: 4 to 8 weeks after the first dose, Third dose: 6 to 12 months after the second dose.
Children older than 7 years who did not complete primary immunization series (e.g., previously received only two doses of DTaP or DTP) need to receive only one dose of tetanus toxoid adsorbed vaccine to complete the primary series of tetanus.
Interruption of the recommended schedule with a delay between doses does not interfere with the final immunity achieved with adsorbed tetanus vaccine. There is no need to start the series over again, regardless of the time elapsed between doses.
Routine booster injections:
To maintain adequate protection, a booster dose of 0.5 ml of adsorbed tetanus vaccine every 10 years thereafter is recommended.
Vaccination of injured persons:
Clean and minor wound:
• If primary immunization confirmed and receiving booster dose within previous 5 years, no need of additional vaccine.
• If primary immunization confirmed and receiving booster dose more than previous 5 years, 1 dose of 0.5 ml required.
All other dirty wounds (contaminated with feces, soil, and saliva):
• If primary immunization confirmed and receiving booster dose within previous 5 years, 1 dose of 0.5 ml required.
• If primary immunization confirmed and receiving booster dose more than previous 5 years, 1 dose of 0.5 ml along with tetanus immunoglobulin required.
If a person has no previous vaccination or uncertain, the primary series of 3 doses of 0.5ml adsorbed tetanus vaccine should be given along with tetanus immunoglobulin with 1st dose.
Protection of neonatal tetanus
For prevention of neonatal tetanus, adsorbed tetanus vaccine is recommended for immunization of women of childbearing age.
TT-1: At age of 15 years,
TT-2: 4 weeks after TT-1,
TT-3: 6 months after TT-2,
TT-4: 1 year after TT-3,
TT-5: 1 year after TT-4.
For pregnant woman who have not had previous immunization, at least 2 doses of tetanus toxoid at four weeks interval,
Pregnant woman who have completed the course of tetanus, next 10 years no need of additional dose during pregnancy. Thereafter a single booster dose would be sufficient to extend immunity.
Child Dose
Primary immunization for persons 7 years of age and older:
A series of three doses of 0.5 ml each, of adsorbed tetanus vaccine should be given intramuscularly;
First dose: At appropriate date, Second dose: 4 to 8 weeks after the first dose, Third dose: 6 to 12 months after the second dose.
Children older than 7 years who did not complete primary immunization series (e.g., previously received only two doses of DTaP or DTP) need to receive only one dose of tetanus toxoid adsorbed vaccine to complete the primary series of tetanus.
Interruption of the recommended schedule with a delay between doses does not interfere with the final immunity achieved with adsorbed tetanus vaccine. There is no need to start the series over again, regardless of the time elapsed between doses.
Routine booster injections:
To maintain adequate protection, a booster dose of 0.5 ml of adsorbed tetanus vaccine every 10 years thereafter is recommended.
Renal Dose
Administration
IM injection only. Do not administer IV. Use subcutaneous route in bleeding disorders.
Adults and older children should be given IM in deltoid muscle. For infants should be given IM in anterior lateral aspect of the upper thigh. Shouldnot be given in gluteal areas.
Contra Indications
Hypersensitivity to any component of the vaccine, including thiomersal, is a contraindication. This vaccine is contraindicated in patients with previous hypersensitivity to any tetanus-containing vaccine. Tetanus toxoid vaccination should be defferred during the course of any febrile illness or acute infection. A minor febrile illness such as a mild upper respiratory infection should not preclude immunization.
Precautions
Withhold vaccination in moderate or severe febrile illness. History of Guillian-Barre syndrome. Pregnancy.
Lactation: it is not known if tetanus toxoid is excreted in human milk. It may be administered to nursing mothers only if clearly needed.
Pregnancy-Lactation
Pregnancy Category: C
Lactation: not known if excreted in breast milk
Interactions
Decreased immunologic response with concurrent immunosuppressants. Neutralisation of tetanus immune globulin and tetanus toxoid adsorbed if not given at different sites using different syringes.
Side Effects
Side effects of Tetanus toxoid (Absorbed Tetanus) Vaccine :
Adsorbed tetanus vaccine is generally well tolerated. Most recipients of tetanus vaccine experience some reactions upon vaccination. These are generally moderate and short in duration. They mainly consist of local reactions at the injection site (erythema, induration and tenderness). Systemic reactions (malaise and elevated temperature) are reported less commonly.
Mode of Action
Tetanus toxoid adsorbed induces active immunity to the tetanus antigen by stimulating the immune system to produce specific antitoxin. They are not indicated for the treatment of active tetanus infection.