TETANUS-DIPHTHERIA VACCINE (Td)

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    Indications

    • Prevention of tetanus in wound management
    • Prevention of tetanus and diphtheria in pregnant women or women of childbearing age
    • Prevention of tetanus and diphtheria in children over 4 years and adolescents (booster dose after complete primary vaccination)

    Composition, forms, route of administration

    • Bivalent vaccine combining tetanus toxoid and diphtheria toxoid (containing reduced dose of diphtheria toxoid)

    • Suspension for injection in multidose vial, for IM injection into the deltoid muscle

    Dosage and vaccination schedule

    Child and adult: 0.5 ml per dose

     

    Prevention of tetanus in wound management

     

    Type of wound

    Complete vaccination (3 or more doses)
    Time since administration of last dose

    Incomplete vaccination

    (less than 3 doses)
    or no vaccination
    or unknown status

    < 5 years

    5-10 years

    > 10 years

    Minor, clean

    None

    None

    Td
    1 booster dose

    Initiate (a) Citation a. 2 doses 4 weeks apart then 3 additional doses administered according to the vaccination schedule below. or complete tetanus vaccination
    Other None Td
    1 booster dose    		 Td
    1 booster dose    		 Initiate (a) Citation a. 2 doses 4 weeks apart then 3 additional doses administered according to the vaccination schedule below. or complete tetanus vaccination
    and administer tetanus immunoglobulin

    Prevention of tetanus in pregnant women and women of childbearing age
    5 doses administered according to the schedule below:

     

    Td1

    On first contact with the health care system or as soon as possible during pregnancy

    Td2

    At least 4 weeks after Td1

    Td3

    6 months to 1 year after Td2 or during the following pregnancy

    Td4

    1 to 5 years after Td3 or during the following pregnancy

    Td5

    1 to 10 years after Td4 or during the following pregnancy

     

    In pregnant women, administer at least 2 doses before delivery: the 1st dose as soon as possible during pregnancy and the 2nd dose at least 4 weeks after the 1st  and at least 2 weeks before due date. After delivery, continue vaccination as described in the table above until the required 5 doses have been administered.

     

    Prevention of tetanus in children over 4 years (after complete primary vaccination and 1st booster between 12 and 23 months)

    Booster dose between 4 and 7 years then between 9 and 15 years

    Contra-indications, adverse effects, precautions

    • Do not administer in the event of allergic reactions after a previous dose of tetanus or diphtheria vaccine.
    • Vaccination should be postponed in the event of severe acute febrile illness; minor infections are not contra-indications.
    • May cause: mild local reactions (redness, pain at the injection site), fever, pain, malaise; rarely: anaphylactic reactions.
    • If administered simultaneously with other vaccines, use different syringes and injection sites. 
    • Pregnancy and breast-feeding: no contra-indication

    Remarks

    • The monovalent tetanus (TT) vaccine is used in certain national protocols. Use perferably the conjugate tetanus-diphtheria (Td) vaccine for the prevention of tetanus in children over 7 years, adolescents and adults.
    • Tetanus vaccination in pregnant women and women of child bearing age protects neonates from tetanus.

    Storage

     
    – Between 2 °C and 8 °C. Do not freeze.
    • (a) 2 doses 4 weeks apart then 3 additional doses administered according to the vaccination schedule below.
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