Tetanus Toxoid

Registered South African indications:

• Long-term prophylaxis
• Post-exposure prophylaxis
• Neonatal prophylaxis in women of childbearing age

Contraindications

Pre-exposure prophylaxis

• Hypersensitivity to the active ingredient or any of its excipients
• Postpone vaccination if fever, acute disease or evolutive chronic disease
• Hypersensitivity reaction or neurological disorder after a previous injection of the vaccine

Post-exposure prophylaxis

• No contraindications

Cautions

• Pregnancy
• Breastfeeding
• Immunocompromised patients

Forms avail. in SA and covered in this monograph: inj

Primary immunisation

• IM: 40 IU (0.5ml); Immunisation schedule: Give dose at 0, 1-2 and 6-12 months

In adults it is advisable to use combined vaccines for primary vaccination

Booster immunisations for longterm prophylaxis of tetanus

• IM: 40 IU (0.5ml), every 10 years after completion of primary immunisations

Neonatal tetanus prophylaxis - maternal dose

• IM: 40 IU (0.5ml), given at least 90 days before delivery; Repeat second dose after a minimum interval of 4 weeks

It has been reported that a third dose given the following year or in subsequent pregnancy offers protection for newborns for at least 5 additional years; A fourth dose provides protection for 10 years

Tetanus prophylaxis in wound management

Single dose (booster)

• IM: 40 IU (0.5ml)

Complete vaccination schedule

• IM: 40 IU (0.5ml); Repeat dose at 1-2 months and 6-12 months and every 10 years thereafter

Paed. forms avail. in SA and covered in this monograph: inj

Primary immunisation 

Younger than 7 years

• IM: 40 IU (0.5ml); Immunisation schedule: Give dose at 6, 10, 14 weeks and 18 months after birth; Booster dose at 5-7 years and again at 12-15 years of age

Older than 7 years

• IM: 40 IU (0.5ml) as a single dose; Booster dose after 10 years

Incomplete primary immunisations - Reimmunistion

Younger than 7 years

• IM: 40 IU (0.5ml) as a single dose; Booster dose after 10 years

Tetanus prophylaxis in wound management 
- Clean, minor wound and primary immunisation complete

Older than 7 years

• No need for further doses

Tetanus prophylaxis in wound management 
- Clean, minor wound and primary immunisation incomplete (less than 3 doses)
- Clean, minor wound with unknown immune status
- Large, contaminated wounds

Older than 7 years

• IM: 40 IU (0.5ml) as a single dose

Pregnancy

• Caution
• There have been no animal studies conducted to determine the safety of tetanus toxoid. Vaccination of pregnant women who may give birth in unhygienic conditions is recommended if they unvaccinated or have not completed the full vaccination schedule. Increased risk of foetal adverse events has not been observed with the use of tetanus toxoid during pregnancy

Breastfeeding

• Caution
• Use of tetanus toxoid is acceptable during breastfeeding. Vaccination of breastfeeding infants should be as recommended by national schedule

Renal Impairment

• No dose adjustment recommended

Hepatic Impairment

• No dose adjustment recommended

Elderly

• No dose adjustment recommended

Porphyria Information

• Probably not porphyrinogenic (PNP)

Drugs in Sport

• Permitted - No warnings

Central Nervous System Disorders

• Headache
• Dizziness
• Brachial neutitis
• Guillain-Barre' syndrome
• Malaise

Cardiovascular Disorders

• Hypotension

Musculoskeletal Disorders

• Myalgia
• Arthralgia

Skin and Subcutaneous Tissue Disorders

• Pruritis
• Urticaria
• Erythema
• Subcutaneous nodule
• Injection site reaction
• Aseptic abscess

Immune, Blood and Lymphatic System Disorders

• Lymphadenopathy
• Type I hypersensitivity reactions
• Transient pyrexia

• Belimumab
• Fingolimod
• Immunosuppressants

None routine

Tetanus toxoid preparations contain the toxin produced by virulent tetanus bacilli (detoxified growth products of Clostridium tetani). It has been detoxified by treatment with formaldehyde, but still retains the ability to act as an antigen and produce active immunity.  

Injection (per 0.5ml) 40iu

• Tetavax (Sanofi)